Neurology Unit, Maggiore della Carità Hospital, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, Vercelli, Italy.
Neurology Unit, Maggiore della Carità Hospital, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.
Mult Scler Relat Disord. 2021 Nov;56:103231. doi: 10.1016/j.msard.2021.103231. Epub 2021 Aug 29.
Axonal loss is an important feature of Multiple Sclerosis (MS), being strongly related to irreversible disability accumulation. Nonetheless, the exact mechanisms underlying axonal loss remain unclear. Cerebrospinal fluid (CSF) levels of Tau and Beta-amyloid (Abeta) currently represent diagnostic biomarkers in other neurodegenerative diseases. In MS, studies on CSF Tau and Abeta provided preliminary informations on disease prognosis, but results have not yet been replicated.
We investigated whether CSF Tau and Abeta levels could predict early disability accumulation in MS patients. 100 patients underwent CSF analysis during their diagnostic work-up. Demographic, clinical, radiological features and CSF were collected at baseline. MS severity score (MSSS) and age-related MSSS (ARMSS) were calculated at last follow-up. We performed Mann-Whitney test, Spearman's coefficient, and multiple regression analysis for significant predictors of disability based on CSF Abeta and Tau levels, gender, age at diagnosis and MRI characteristics at baseline.
Baseline CSF Tau levels moderately correlated with MSSS (r=0.372 p=0.0001) and weakly with ARMSS (r=0.237 p=0.0176) after a mean two years follow-up. Predictors of early disability evaluated with MSSS and ARMSS were CSF Tau (Beta:0.258 p=0.009 and Beta:0.252 p=0.01) and spinal cord involvement (Beta:0.196 p=0.029 and Beta:0.240 p=0.008); as well as age at MS diagnosis (Beta:0.286 p=0.001) for MSSS, and high brain lesion load (Beta:0.207 p=0.02) for ARMSS.
CSF Tau levels at diagnosis possibly has a predictive value along with MRI features and age at diagnosis. We hypothesize that Tau levels may express chronic axonal damage, possibly contributing to early MS disability.
轴突丢失是多发性硬化症（MS）的一个重要特征，与不可逆的残疾积累密切相关。尽管如此，导致轴突丢失的确切机制仍不清楚。脑脊液（CSF）中的 Tau 和 Beta-淀粉样蛋白（Abeta）目前是其他神经退行性疾病的诊断生物标志物。在 MS 中，CSF Tau 和 Abeta 的研究提供了疾病预后的初步信息，但结果尚未得到复制。
我们研究了 CSF Tau 和 Abeta 水平是否可以预测 MS 患者的早期残疾积累。100 名患者在诊断过程中接受了 CSF 分析。在基线时收集了人口统计学、临床、影像学特征和 CSF。在最后一次随访时计算了 MS 严重程度评分（MSSS）和年龄相关 MSSS（ARMSS）。我们进行了 Mann-Whitney 检验、Spearman 系数和多元回归分析，以确定基于 CSF Abeta 和 Tau 水平、性别、诊断时年龄和基线 MRI 特征的残疾显著预测因子。
基线 CSF Tau 水平与 MSSS（r=0.372，p=0.0001）和 ARMSS（r=0.237，p=0.0176）在平均 2 年随访后中度相关。使用 MSSS 和 ARMSS 评估的早期残疾预测因子是 CSF Tau（Beta：0.258，p=0.009 和 Beta：0.252，p=0.01）和脊髓受累（Beta：0.196，p=0.029 和 Beta：0.240，p=0.008）；以及 MS 诊断时的年龄（Beta：0.286，p=0.001）用于 MSSS，以及大脑病变负荷高（Beta：0.207，p=0.02）用于 ARMSS。
诊断时的 CSF Tau 水平可能与 MRI 特征和诊断时的年龄一起具有预测价值。我们假设 Tau 水平可能表达慢性轴突损伤，可能导致早期 MS 残疾。
