多发性硬化症发病时神经丝水平与9年后认知表现之间的弱关联。
The weak association between neurofilament levels at multiple sclerosis onset and cognitive performance after 9 years.
作者信息
Friedova Lucie, Motyl Jiri, Srpova Barbora, Oechtering Johanna, Barro Christian, Vodehnalova Karolina, Andelova Michaela, Noskova Libuse, Fialová Lenka, Havrdova Eva Kubala, Horakova Dana, Benedict Ralph Hb, Kuhle Jens, Uher Tomas
机构信息
Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague, Czech Republic.
Departments of Medicine, Clinical Research, Biomedicine and Biomedical Engineering, Neurologic Clinic and Policlinic, University Hospital and University of Basel, Switzerland.
出版信息
Mult Scler Relat Disord. 2020 Nov;46:102534. doi: 10.1016/j.msard.2020.102534. Epub 2020 Sep 28.
BACKGROUND
Neurofilament light chain level in serum (sNfL) and cerebrospinal fluid (CSF-NfL) is a promising biomarker of disease activity in multiple sclerosis (MS). However, predictive value of neurofilaments for development of cognitive decline over long-term follow-up has not been extensively studied.
OBJECTIVE
To investigate the relationship between early neurofilament levels and cognitive performance after 9-years.
METHODS
We included 58 MS patients from the SET study. sNfL levels were measured at screening, at 1 and 2 years. CSF-NfL were measured in 36 patients at screening. Cognitive performance was assessed by the Brief International Cognitive Assessment for Multiple Sclerosis and the Paced Auditory Serial Addition Test-3 s at baseline, at 1, 2 and 9 years. Association between neurofilament levels and cognition was analyzed using Spearman´s correlation, logistic regression and mixed models.
RESULTS
We did not observe associations among early sNfL levels and cross-sectional or longitudinal cognitive measures, except of a trend for association between higher sNfL levels at screening and lower California Verbal Learning Test-II (CVLT-II) scores at year 1 (rho=-0.31, unadjusted p = 0.028). Higher sNfL level was not associated with increased risk of cognitive decline, except of a trend for greater risk of CVLT-II decrease in patients with higher sNfL levels at 1 year (OR=15.8; 95% CI=1.7-147.0; unadjusted p = 0.015). Similar trends were observed for CSF-NfL.
CONCLUSION
We found only weak association between sNfL levels at disease onset and evolution of cognitive performance over long-term follow-up.
背景
血清神经丝轻链水平（sNfL）和脑脊液神经丝轻链水平（CSF-NfL）是多发性硬化症（MS）疾病活动的一种有前景的生物标志物。然而，在长期随访中神经丝对认知功能下降发展的预测价值尚未得到广泛研究。
目的
研究早期神经丝水平与9年后认知表现之间的关系。
方法
我们纳入了SET研究中的58例MS患者。在筛查时、1年和2年时测量sNfL水平。在36例患者的筛查时测量CSF-NfL。在基线、1年、2年和9年时，通过简短国际多发性硬化症认知评估和3秒节奏听觉连续加法测验评估认知表现。使用Spearman相关性分析、逻辑回归和混合模型分析神经丝水平与认知之间的关联。
结果
我们未观察到早期sNfL水平与横断面或纵向认知指标之间存在关联，但筛查时较高的sNfL水平与第1年较低的加利福尼亚言语学习测验-II（CVLT-II）分数之间存在关联趋势（rho=-0.31，未校正p=0.028）。较高的sNfL水平与认知功能下降风险增加无关，但1年时sNfL水平较高的患者CVLT-II下降风险更大存在趋势（OR=15.8；95%CI=1.7-147.0；未校正p=0.015）。CSF-NfL也观察到类似趋势。
结论
我们发现疾病发作时的sNfL水平与长期随访中认知表现的演变之间仅存在微弱关联。
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