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Plasma Neurofilament Light Chain Is Associated with Cognitive Functions but Not Patient-Reported Outcomes in Multiple

Valerio Nicolella1, Federica Novarella1, Fabrizia Falco1,2

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Plasma neurofilament light chain (pNfL) in multiple sclerosis (MS) correlates with disability and cognitive processing speed. Higher education may offer neuroprotection, while patient-reported outcomes showed no significant pNfL associations.

Keywords:
cognitivemultiple sclerosisneurofilamentpatient-reported outcomes

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Area of Science:

  • Neuroscience
  • Clinical Neurology
  • Biomarker Research

Background:

  • Multiple Sclerosis (MS) is a chronic neurological disease characterized by neuroinflammation and neurodegeneration.
  • Plasma neurofilament light chain (pNfL) is a sensitive biomarker of neuro-axonal damage in MS.
  • Understanding the relationship between pNfL, cognitive function, and patient-reported outcomes (PROs) is crucial for MS management.

Purpose of the Study:

  • To investigate the associations between plasma neurofilament light chain (pNfL) levels and cognitive performance in people with MS (PwMS).
  • To explore the relationship between pNfL and various patient-reported outcomes (PROs) including fatigue, depression, anxiety, and sleep quality.
  • To determine the influence of demographic factors like educational attainment on pNfL levels in MS.

Main Methods:

  • A cross-sectional study involving 211 people with MS (PwMS).
  • Data collection included plasma pNfL levels, Expanded Disability Status Scale (EDSS), cognitive tests (SDMT, CVLT II, BVMT-R), and PROs (MFIS, BDI-II, BAI, PSQI).
  • Statistical analyses employed multivariate linear regression and logistic regression models.

Main Results:

  • Higher educational attainment was significantly associated with lower pNfL levels.
  • Increased EDSS scores and impaired Symbol Digit Modalities Test (SDMT) performance were linked to higher pNfL levels.
  • No significant associations were found between pNfL and other cognitive tests (CVLT II, BVMT-R) or PROs (MFIS, BDI-II, BAI, PSQI).

Conclusions:

  • Neuro-axonal damage in MS is associated with increased disability and reduced attention/processing speed.
  • Higher educational attainment may confer a protective effect against neuro-axonal damage in MS.
  • The PROs assessed did not show significant associations with pNfL, potentially due to measurement limitations or heterogeneity.