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The following is a summary of “Neurofilament heavy chain in secondary progressive multiple sclerosis,” published in the January 2025 issue of Neurology by Angelis et al.
Biomarkers are essential for monitoring progression in multiple sclerosis (MS) trials. Neurofilament heavy chain (NfH) has been underused due to limitations in current assay methods.
Researchers conducted a retrospective study to investigate the added value of cerebrospinal fluid (CSF) NfH in secondary progressive multiple sclerosis (SPMS) using modern immunoassays.
They performed an exploratory study as part of the MS-SMART trial. Clinical assessments (including Expanded Disability Status Scale, upper and lower limb function, visual acuity, and Symbol Digit Modality Test [SDMT]), CSF and serum samples were collected at baseline (n = 54), 48, and 96 weeks. Brain magnetic resonance imaging (MRI) scans were obtained at baseline and 96 weeks. Neurofilament light chain (NfL) and NfH were measured using a single-molecule array assay.
The results showed baseline CSF NfH and NfL correlated with information processing speed at 96 weeks, with CSF NfH showing a stronger correlation (r = −0.49 for SDMT) than CSF NfL (r = −0.37 for SDMT). Baseline CSF NfL predicted poorer hand dexterity at baseline, 48 and 96 weeks, CSF NfH was the sole predictor of cortical grey matter at baseline, while CSF NfL was the only predictor of brain atrophy at 96 weeks and the serum neurofilaments had limited associations.
Investigators concluded that CSF neurofilaments predicted better outcomes than serum neurofilaments in SPMS, with CSF NfH and NfL varying in the ability to predict worsening hand function, information processing speed, and brain volume loss, potentially reflecting complementary aspects of neurodegeneration.
Source: journals.sagepub.com/doi/full/10.1177/13524585241311212
