NfL and GFAP in serum are associated with microstructural brain damage in progressive multiple sclerosis

Area of Science:

• Neuroscience
• Biomarkers
• Multiple Sclerosis Research

Background:

• The utility of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) as biomarkers for disease activity and severity in progressive multiple sclerosis (MS) requires further clarification.
• Current understanding of these protein biomarkers in relation to the specific pathological changes in progressive MS is limited.

Purpose of the Study:

• To investigate the association between serum concentrations of NfL and GFAP and magnetic resonance imaging (MRI) findings in patients with progressive MS.
• To explore the relationship between these biomarkers and clinical disability progression over time.

Main Methods:

• Serum NfL and GFAP levels were quantified in 32 healthy controls and 32 progressive MS patients over a three-year follow-up period.
• Clinical data, including the Expanded Disability Status Scale (EDSS), and advanced MRI techniques such as diffusion tensor imaging (DTI) were collected.

Main Results:

• Progressive MS patients exhibited higher serum NfL and GFAP concentrations compared to healthy controls.
• Serum NfL levels correlated with EDSS scores, while decreasing fractional anisotropy (FA) in normal-appearing white matter (NAWM) correlated with worsening EDSS and elevated NfL.
• High serum NfL was independently associated with reduced FA and increased mean diffusivity (MD) in NAWM. High serum GFAP was linked to altered MD and FA in both NAWM and cortical gray matter (CGM).

Conclusions:

• Serum NfL and GFAP levels are elevated in progressive MS.
• These biomarkers are significantly associated with specific microstructural alterations in both white and gray matter, as detected by DTI.