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Updated: May 31, 2025
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Author Spotlight: Unveiling the Pathway Linking Obesity to Autoimmune Inflammation in Multiple Sclerosis
Published on: February 23, 2024
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Neurofilament heavy chain in secondary progressive multiple sclerosis
Floriana De Angelis1,2, Francesca Ammoscato3, Richard A Parker4
1Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|January 23, 2025
Summary
Cerebrospinal fluid (CSF) neurofilament heavy chain (NfH) and neurofilament light chain (NfL) show promise as biomarkers for tracking multiple sclerosis (MS) progression. These CSF neurofilaments better predict disease worsening than serum markers.
Area of Science:
- Neuroscience
- Biomarker Discovery
- Clinical Neurology
Background:
- Biomarkers are crucial for monitoring disease progression in multiple sclerosis (MS) clinical trials.
- Neurofilament heavy chain (NfH) has been underutilized due to assay limitations.
Purpose of the Study:
- To evaluate the added value of cerebrospinal fluid (CSF) NfH in secondary progressive multiple sclerosis (SPMS) using modern immunoassays.
- To compare the utility of CSF NfH and NfL as biomarkers in SPMS.
Main Methods:
- Exploratory study within the MS-SMART trial involving 54 participants.
- Collected clinical data, CSF, and serum samples at baseline, 48, and 96 weeks.
- Measured CSF and serum NfL and NfH using single-molecule array assay; brain MRIs acquired at baseline and 96 weeks.
Main Results:
- Baseline CSF NfH and NfL correlated with 96-week information processing speed (SDMT), with NfH showing stronger correlation (r = -0.49) than NfL (r = -0.37).
- Baseline CSF NfL predicted poorer hand dexterity and brain atrophy, while CSF NfH predicted cortical grey matter volume.
- Serum neurofilaments demonstrated limited associations with clinical outcomes.
Conclusions:
- CSF neurofilaments (NfH and NfL) are superior to serum neurofilaments as outcomes in small SPMS studies.
- CSF NfH and NfL variably predict hand function decline, cognitive impairment, and brain volume loss, potentially reflecting distinct neurodegeneration pathways.
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