Predictive value of brain atrophy, serum biomarkers and information processing speed for early disease progression in multiple sclerosis

Frontiers in Neurology

Neurology

Małgorzata Siger¹  Magdalena Oset¹  Iwona Karlińska¹  Mariusz Stasiołek¹  Małgorzata Domowicz¹  Paula Wildner¹  Mariola Świderek-Matysiak² 

[1] Department of Neurology, Medical University of Lodz, Lodz, Poland;null;

关键词: multiple sclerosis;    predictive factors;    neurofilament light chain;    bicaudate ratio;    third ventricle width;   

DOI  :  10.3389/fneur.2023.1223220

 received in 2023-05-15, accepted in 2023-07-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionMultiple sclerosis (MS) is a chronic autoimmune-mediated demyelinating disease of the central nervous system (CNS). A clinical presentation of the disease is highly differentiated even from the earliest stages of the disease. The application of stratifying tests in clinical practice would allow for improving clinical decision-making including a proper assessment of treatment benefit/risk balance.MethodsThis prospective study included patients with MS diagnosed up to 1 year before recruitment. We analyzed serum biomarkers such as CXCL13, CHI3L1, OPN, IL-6, and GFAP and neurofilament light chains (NfLs); brain MRI parameters of linear atrophy such as bicaudate ratio (BCR), third ventricle width (TVW); and information processing speed were measured using the Symbol Digit Modalities Test (SDMT) during the 2 years follow-up.ResultsThe study included a total of 50 patients recruited shortly after the diagnosis of MS diagnosis (median 0 months; range 0–11 months), and the mean time of observation was 28 months (SD = 4.75). We observed a statistically significant increase in the EDSS score (Wilcoxon test: Z = 3.06, p = 0.002), BCR (Wilcoxon test: Z = 4.66, p < 0.001), and TVW (Wilcoxon test: Z = 2.84, p = 0.005) after 2 years of disease. Patients who had a significantly higher baseline level of NfL suffered from a more severe disease course as per the EDSS score (Mann–Whitney U-test: U = 107, Z = −2,74, p = 0.006) and presence of relapse (Mann–Whitney U-test: U = 188, Z = −2.01, p = 0.044). In the logistic regression model, none of the parameters was a significant predictor for the achieving of no evidence of disease activity status (NEDA). In the model considering all assessed parameters, only the level of NfL had a significant impact on disease progression, measured as the increase in EDSS (logistic regression: β = 0.002, p = 0.017).ConclusionWe confirmed that NfL levels in serum are associated with more active disease. Moreover, we found that TVW at the time of diagnosis was associated with an impairment in cognitive function measured by information processing speed at the end of the 2-year observation. The inclusion of serum NfL and TVW assessment early in the disease may be a good predictor of disease progression independent of NEDA.

【 授权许可】

Unknown   
Copyright © 2023 Oset, Domowicz, Wildner, Siger, Karlińska, Stasiołek and Świderek-Matysiak.