Publications & Posters

Serum Neurofilament Light Chain Is A Biomarker Of Acute And Chronic Neuronal Damage In Early Multiple Sclerosis


Nelly Siller, Jens Kuhle, Muthuraman Muthuraman, Christian Barro, Timo Uphaus,
Sergiu Groppa, Ludwig Kappos, Frauke Zipp and Stefan Bittner

Multiple Sclerosis Journal

DOI: 10.1177/1352458518765666


Background: Monitoring neuronal injury remains one key challenge in early relapsing-remitting multiple
sclerosis (RRMS) patients. Upon axonal damage, neurofilament – a major component of the neuroaxonal
cytoskeleton – is released into the cerebrospinal fluid (CSF) and subsequently peripheral blood.
Objective: To investigate the relevance of serum neurofilament light chain (sNfL) for acute and chronic
axonal damage in early RRMS.

Methods: sNfL levels were determined in 74 patients (63 therapy-naive) with recently diagnosed clinically
isolated syndrome (CIS) or RRMS using Single Molecule Array technology. Standardized 3 T magnetic
resonance imaging (MRI) was performed at baseline and 1–3 consecutive follow-ups (42 patients;
range: 6–37 months).

Results: Baseline sNfL correlated significantly with T2 lesion volume (r = 0.555, p < 0.0001). There was
no correlation between baseline sNfL and age, Expanded Disability Status Scale (EDSS) score or other
calculated MRI measures. However, T2 lesion volume increased (r = 0.67, p < 0.0001) and brain parenchymal
volume decreased more rapidly in patients with higher baseline sNfL (r = −0.623, p = 0.0004).
Gd-enhancing lesions correlated positively with sNfL levels. Initiation of disease-modifying treatment
led to a significant decrease in sNfL levels.

Conclusion: sNfL indicates acute inflammation as demonstrated by correlation with Gd+ lesions. It is
a promising biomarker for neuro-axonal damage in early multiple sclerosis (MS) patients, since higher
baseline sNfL levels predicted future brain atrophy within 2 years.