Contributions
Abstract: P630
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 25 Biomarkers
Background and objective: Axonal damage is considered one of the major causes of persisting neurological disability in multiple sclerosis (MS). A promising biomarker for axonal damage early in the disease course of MS is neurofilament light chain (NfL). A correlation has been found between CSF NfL in adult patients with clinically isolated syndrome (CIS) and disease progression. Whether NfL is also increased at disease onset in children is still unknown.
Our first aim was to compare CSF neurofilament light chain (NfL) levels between children and adults at time of a first demyelinating event. The second aim was to explore the predictive value of NfL in pediatric and adult CIS patients. Finally, we investigated the association between NfL and T1-hypointense lesions on MRI.
Methods: We included 88 adult and 65 pediatric patients with follow-up since a first attack of demyelination and 30 controls. NfL levels were determined in CSF using a commercially available ELISA. COX regression analyses were used to calculate univariate and multivariate hazard ratios (HR) for clinically defined MS (CDMS) diagnosis.
Results: Patients with a first demyelinating event had higher CSF NfL levels than controls (geometric mean 2040 pg/mL vs 444 pg/mL; p< 0.001). For CIS patients with a future CDMS diagnosis, children showed higher NfL levels than adults (geometric mean 4888 pg/mL vs 2110 pg/mL; p=0.006). After adjustments for age at onset, oligoclonal bands, and >9 T2-lesions on baseline MRI, increased NfL levels in both pediatric and adult CIS patients were associated with a shorter time to CDMS diagnosis
(children HR 3.5; p=0.035, adults HR 2.1; p=0.033).
Additionally, NfL was higher in patients with T1-hypointense lesions than in patients without T1-hypointense lesions on baseline MRI in adults (geometric mean 3051 pg/mL vs 1798 pg/mL; p=0.024) and children (geometric mean 7073 pg/mL vs 1890 pg/mL; p=0.020).
Conclusions: CSF NfL levels are associated with CDMS diagnosis in children and adults with CIS. This makes NfL a promising predictive marker for disease course with potential value in clinical practice.
Disclosure:
Roos M. van der Vuurst de Vries: Nothing to disclose
Yu Yi M. Wong: Nothing to disclose
Julia Y. Mescheriakova: Nothing to disclose
E. Daniëlle van Pelt: Nothing to disclose
Tessel F. Runia: Nothing to disclose
Naghmeh Jafari: Received honoraria for giving a lecture from Biogen Idec
Theodora A.M. Siepman: Nothing to disclose
Marie-José Melief: Nothing to disclose
Annet F. Wierenga-Wolf: Nothing to disclose
Marvin M. van Luijn: Nothing to disclose
Johnny P. Samijn: Received honoraria for serving on advisory boards for Merck-Serono and Genzyme. Received travel grants from Merck-Serono. He participated in trials with BiogenIdec, Merck-Serono, Roche and Genzyme
Rinze F. Neuteboom: Nothing to disclose
Rogier Q. Hintzen: Received honoraria for serving on advisory boards for Biogen Idec, Roche, Sanofi. He participated in trials with BiogenIdec, Merck-Serono, Roche, Genzyme and Novartis
Abstract: P630
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 25 Biomarkers
Background and objective: Axonal damage is considered one of the major causes of persisting neurological disability in multiple sclerosis (MS). A promising biomarker for axonal damage early in the disease course of MS is neurofilament light chain (NfL). A correlation has been found between CSF NfL in adult patients with clinically isolated syndrome (CIS) and disease progression. Whether NfL is also increased at disease onset in children is still unknown.
Our first aim was to compare CSF neurofilament light chain (NfL) levels between children and adults at time of a first demyelinating event. The second aim was to explore the predictive value of NfL in pediatric and adult CIS patients. Finally, we investigated the association between NfL and T1-hypointense lesions on MRI.
Methods: We included 88 adult and 65 pediatric patients with follow-up since a first attack of demyelination and 30 controls. NfL levels were determined in CSF using a commercially available ELISA. COX regression analyses were used to calculate univariate and multivariate hazard ratios (HR) for clinically defined MS (CDMS) diagnosis.
Results: Patients with a first demyelinating event had higher CSF NfL levels than controls (geometric mean 2040 pg/mL vs 444 pg/mL; p< 0.001). For CIS patients with a future CDMS diagnosis, children showed higher NfL levels than adults (geometric mean 4888 pg/mL vs 2110 pg/mL; p=0.006). After adjustments for age at onset, oligoclonal bands, and >9 T2-lesions on baseline MRI, increased NfL levels in both pediatric and adult CIS patients were associated with a shorter time to CDMS diagnosis
(children HR 3.5; p=0.035, adults HR 2.1; p=0.033).
Additionally, NfL was higher in patients with T1-hypointense lesions than in patients without T1-hypointense lesions on baseline MRI in adults (geometric mean 3051 pg/mL vs 1798 pg/mL; p=0.024) and children (geometric mean 7073 pg/mL vs 1890 pg/mL; p=0.020).
Conclusions: CSF NfL levels are associated with CDMS diagnosis in children and adults with CIS. This makes NfL a promising predictive marker for disease course with potential value in clinical practice.
Disclosure:
Roos M. van der Vuurst de Vries: Nothing to disclose
Yu Yi M. Wong: Nothing to disclose
Julia Y. Mescheriakova: Nothing to disclose
E. Daniëlle van Pelt: Nothing to disclose
Tessel F. Runia: Nothing to disclose
Naghmeh Jafari: Received honoraria for giving a lecture from Biogen Idec
Theodora A.M. Siepman: Nothing to disclose
Marie-José Melief: Nothing to disclose
Annet F. Wierenga-Wolf: Nothing to disclose
Marvin M. van Luijn: Nothing to disclose
Johnny P. Samijn: Received honoraria for serving on advisory boards for Merck-Serono and Genzyme. Received travel grants from Merck-Serono. He participated in trials with BiogenIdec, Merck-Serono, Roche and Genzyme
Rinze F. Neuteboom: Nothing to disclose
Rogier Q. Hintzen: Received honoraria for serving on advisory boards for Biogen Idec, Roche, Sanofi. He participated in trials with BiogenIdec, Merck-Serono, Roche, Genzyme and Novartis