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NFL during acute spinal cord lesions in MS: a hurdle for the detection of inflammatory activity

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Abstract

Introduction

Levels of neuro-filament light chain (NFL) correlate with clinical and radiological activity in multiple sclerosis (MS) and have been used as a surrogate biomarker of axonal destruction related to inflammatory activity. The main objective of this work is to explore the specific contribution of acute inflammation within the spinal cord to the elevation of NFL levels.

Patients and methods

MS patients with a baseline study of NFL at diagnosis of the disease and a brain and spinal cord MRI scan were selected. Patients were classified according to the presence, number and location of gadolinium enhancing lesion (GEL) and the relationship between NFL levels and both brain and spinal cord GEL were explored.

Results

Seventy-seven patients were selected. NFL levels were significantly higher in patients with only one GEL restricted to the brain than those without GEL (1702 pg/ml vs 722.7 pg/mL, p = 0.03) and correlated with number. However, no differences were seen among patients with GEL limited to the spinal cord and those without GEL (735.2 pg/ml vs 722.7 pg/mL).

Conclusion

Our study reaffirms the value of NFL levels in monitoring asymptomatic inflammatory activity in the brain measured by GEL. However, NFL concentration is not as useful when only inflammatory activity occurs in the spinal cord.

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Abbreviations

CSF:

Cerebrospinal fluid

CSFNFL:

Neuro-filament light chain in cerebrospinal fluid

GEL:

Gadolinium-enhancing lesion

NFL:

Neuro-filament light chain

MRI:

Magnetic resonance imaging

MS:

Multiple sclerosis

pwMS:

Patients with MS

sNFL:

Neuro-filament light chain in serum

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Funding

This work has been supported by a grant from the Health Institute Carlos III (PI20/01446) and FEDER funding.

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Authors and Affiliations

  1. Neuroimmunology Unit, University and Polytechnic Hospital La Fe, Fernando Abril Martorell Avenue 106, 46026, Valencia, Spain

    C. Alcalá, L. Cubas, S. Carratalá, C. Quintanilla-Bordás, S. Gil-Perotín, D. Gorriz, F. Pérez-Miralles, R. Gasque, J. Castillo & B. Casanova

  2. Neurology Department, University Hospital Clinic of Valencia, Blasco Ibañez Avenue, 17, 46010, Valencia, Spain

    F. Gascón

Authors
  1. C. Alcalá
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  2. L. Cubas
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  3. S. Carratalá
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  4. F. Gascón
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  5. C. Quintanilla-Bordás
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  6. S. Gil-Perotín
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  7. D. Gorriz
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  8. F. Pérez-Miralles
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  9. R. Gasque
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  10. J. Castillo
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  11. B. Casanova
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Corresponding author

Correspondence to C. Alcalá.

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The authors report no competing interests.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional (University and Polytechnic Hospital La Fe, Valencia, Spain) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Alcalá, C., Cubas, L., Carratalá, S. et al. NFL during acute spinal cord lesions in MS: a hurdle for the detection of inflammatory activity. J Neurol 269, 3495–3500 (2022). https://doi.org/10.1007/s00415-021-10926-7

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  • DOI: https://doi.org/10.1007/s00415-021-10926-7

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