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Cerdá-Fuertes N, Stoessel M, Mickeliunas G, Pless S, Cagol A, Barakovic M, Maceski AM, Álvarez González C, D’ Souza M, Schaedlin S, Benkert P, Calabrese P, Gugleta K, Derfuss T, Sprenger T, Granziera C, Naegelin Y, Kappos L, Kuhle J, Papadopoulou A. Optical coherence tomography versus other biomarkers: Associations with physical and cognitive disability in multiple sclerosis. Mult Scler 2023; 29:1540-1550. [PMID: 37772490 PMCID: PMC10637109 DOI: 10.1177/13524585231198760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Optical coherence tomography (OCT) is a biomarker of neuroaxonal loss in multiple sclerosis (MS). OBJECTIVE The objective was to assess the relative role of OCT, next to magnetic resonance imaging (MRI) and serum markers of disability in MS. METHODS A total of 100 patients and 52 controls underwent OCT to determine peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layers (GCIPL). Serum neurofilament light chain (sNfL), total lesion volume (TLV), and brain parenchymal fraction (BPF) were also assessed. The associations of OCT with disability were examined in linear regression models with correction for age, vision, and education. RESULTS In patients, pRNFL was associated with the Symbol Digit Modalities Test (SDMT; p = 0.030). In the multivariate analysis including sNfL and MRI measures, pRNFL (β = 0.19, p = 0.044) and TLV (β = -0.24, p = 0.023) were the only markers associated with the SDMT. pRNFL (p < 0.001) and GCIPL (p < 0.001) showed associations with the Expanded Disability Status Scale (EDSS). In the multivariate analysis, GCIPL showed the strongest association with the EDSS (β = -0.32, p < 0.001) followed by sNfL (β = 0.18, p = 0.024). CONCLUSION The associations of OCT measures with cognitive and physical disability were independent of serum and brain MRI markers of neuroaxonal loss. OCT can be an important tool for stratification in MS, while longitudinal studies using combinations of biomarkers are warranted.
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Affiliation(s)
- Nuria Cerdá-Fuertes
- Department of Clinical Research, University Hospital of Basel, University of Basel, Basel, Switzerland
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
- Neurostatus AG, University Hospital of Basel, Basel, Switzerland
| | - Marc Stoessel
- Department of Clinical Research, University Hospital of Basel, University of Basel, Basel, Switzerland
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
| | | | - Silvan Pless
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
- Faculty of Psychology and interdisciplinary Platform Psychology and Psychiatry, Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Alessandro Cagol
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
| | - Muhamed Barakovic
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
| | | | | | - Marcus D’ Souza
- Neurostatus AG, University Hospital of Basel, Basel, Switzerland
| | - Sabine Schaedlin
- Department of Clinical Research, University Hospital of Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
| | - Pascal Benkert
- Department of Clinical Research, University Hospital of Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
| | - Pasquale Calabrese
- Faculty of Psychology and interdisciplinary Platform Psychology and Psychiatry, Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Konstantin Gugleta
- University Eye Clinic Basel, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Tobias Derfuss
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital of Basel, Basel, Switzerland
| | - Till Sprenger
- Department of Neurology, DKD Helios Klinik Wiesbaden, Wiesbaden, Germany
| | - Cristina Granziera
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital of Basel, Basel, Switzerland
| | - Yvonne Naegelin
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital of Basel, Basel, Switzerland
| | - Ludwig Kappos
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
| | - Jens Kuhle
- Department of Clinical Research, University Hospital of Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital of Basel, Basel, Switzerland
| | - Athina Papadopoulou
- Department of Clinical Research, University Hospital of Basel, University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience, University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital of Basel, Basel, Switzerland
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Salvioli S, Basile MS, Bencivenga L, Carrino S, Conte M, Damanti S, De Lorenzo R, Fiorenzato E, Gialluisi A, Ingannato A, Antonini A, Baldini N, Capri M, Cenci S, Iacoviello L, Nacmias B, Olivieri F, Rengo G, Querini PR, Lattanzio F. Biomarkers of aging in frailty and age-associated disorders: State of the art and future perspective. Ageing Res Rev 2023; 91:102044. [PMID: 37647997 DOI: 10.1016/j.arr.2023.102044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023]
Abstract
According to the Geroscience concept that organismal aging and age-associated diseases share the same basic molecular mechanisms, the identification of biomarkers of age that can efficiently classify people as biologically older (or younger) than their chronological (i.e. calendar) age is becoming of paramount importance. These people will be in fact at higher (or lower) risk for many different age-associated diseases, including cardiovascular diseases, neurodegeneration, cancer, etc. In turn, patients suffering from these diseases are biologically older than healthy age-matched individuals. Many biomarkers that correlate with age have been described so far. The aim of the present review is to discuss the usefulness of some of these biomarkers (especially soluble, circulating ones) in order to identify frail patients, possibly before the appearance of clinical symptoms, as well as patients at risk for age-associated diseases. An overview of selected biomarkers will be discussed in this regard, in particular we will focus on biomarkers related to metabolic stress response, inflammation, and cell death (in particular in neurodegeneration), all phenomena connected to inflammaging (chronic, low-grade, age-associated inflammation). In the second part of the review, next-generation markers such as extracellular vesicles and their cargos, epigenetic markers and gut microbiota composition, will be discussed. Since recent progresses in omics techniques have allowed an exponential increase in the production of laboratory data also in the field of biomarkers of age, making it difficult to extract biological meaning from the huge mass of available data, Artificial Intelligence (AI) approaches will be discussed as an increasingly important strategy for extracting knowledge from raw data and providing practitioners with actionable information to treat patients.
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Affiliation(s)
- Stefano Salvioli
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | | | - Leonardo Bencivenga
- Department of Translational Medical Sciences, University of Naples Federico II, Napoli, Italy
| | - Sara Carrino
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Maria Conte
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Sarah Damanti
- IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milano, Italy
| | - Rebecca De Lorenzo
- IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milano, Italy
| | - Eleonora Fiorenzato
- Parkinson's Disease and Movement Disorders Unit, Center for Rare Neurological Diseases (ERN-RND), Department of Neurosciences, University of Padova, Padova, Italy
| | - Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, Italy; EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Assunta Ingannato
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Angelo Antonini
- Parkinson's Disease and Movement Disorders Unit, Center for Rare Neurological Diseases (ERN-RND), Department of Neurosciences, University of Padova, Padova, Italy; Center for Neurodegenerative Disease Research (CESNE), Department of Neurosciences, University of Padova, Padova, Italy
| | - Nicola Baldini
- IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Miriam Capri
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Simone Cenci
- IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milano, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, Italy; EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Ancona, Italy; Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples Federico II, Napoli, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Telese Terme, Telese Terme, Italy
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Elmers J, Colzato LS, Akgün K, Ziemssen T, Beste C. Neurofilaments - Small proteins of physiological significance and predictive power for future neurodegeneration and cognitive decline across the life span. Ageing Res Rev 2023; 90:102037. [PMID: 37619618 DOI: 10.1016/j.arr.2023.102037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
Neurofilaments (NFs) are not only important for axonal integrity and nerve conduction in large myelinated axons but they are also thought to be crucial for receptor and synaptic functioning. Therefore, NFs may play a critical role in cognitive functions, as cognitive processes are known to depend on synaptic integrity and are modulated by dopaminergic signaling. Here, we present a theory-driven interdisciplinary approach that NFs may link inflammation, neurodegeneration, and cognitive functions. We base our hypothesis on a wealth of evidence suggesting a causal link between inflammation and neurodegeneration and between these two and cognitive decline (see Fig. 1), also taking dopaminergic signaling into account. We conclude that NFs may not only serve as biomarkers for inflammatory, neurodegenerative, and cognitive processes but also represent a potential mechanical hinge between them, moreover, they may even have predictive power regarding future cognitive decline. In addition, we advocate the use of both NFs and MRI parameters, as their synthesis offers the opportunity to individualize medical treatment by providing a comprehensive view of underlying disease activity in neurological diseases. Since our society will become significantly older in the upcoming years and decades, maintaining cognitive functions and healthy aging will play an important role. Thanks to technological advances in recent decades, NFs could serve as a rapid, noninvasive, and relatively inexpensive early warning system to identify individuals at increased risk for cognitive decline and could facilitate the management of cognitive dysfunctions across the lifespan.
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Affiliation(s)
- Julia Elmers
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Lorenza S Colzato
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.
| | - Katja Akgün
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.
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Chen Z, Wu LP, Peng TC. Prediabetes is associated with a higher serum neurofilament light chain level in adolescents. Front Endocrinol (Lausanne) 2023; 14:1207045. [PMID: 37435483 PMCID: PMC10332149 DOI: 10.3389/fendo.2023.1207045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/06/2023] [Indexed: 07/13/2023] Open
Abstract
Objective Serum neurofilament light chain (sNfL) level, which is a biomarker indicative of neuroaxonal damage and cognitive impairment, has been reported in several neurological diseases. There has been a lack of studies on the association between sNfL levels and prediabetes in adolescents. This study investigated whether sNfL levels were higher in adolescents with prediabetes undergoing elective orthopedic surgery. Methods The sNfL level was measured in 149 adolescents aged from 12 to 18 years who underwent elective orthopedic surgery at the Hunan Children's Hospital (18 with and 131 without prediabetes). We evaluated the association between prediabetes and sNfL level after adjusting for age, sex, and triglycerides using a multivariable linear regression model. Results The prevalence of prediabetes in adolescents was 12.08%. Univariate logistic regression analysis showed that prediabetes was related to sNfL. In multivariate logistic regression analysis, the association between prediabetes with sNfL levels remained significant after adjustment for age, sex, and triglyceride. The relationship between the two was further visualized by a smoothed curve. Conclusions Prediabetes is associated with a higher sNfL. Further large-scale and prospective studies are needed to verify the clinical application of sNfL as a monitoring biomarker for adolescent prediabetes in adolescents and to evaluate the performance of sNfL in predicting the incidence of neuropathy and cognitive dysfunction in adolescents with prediabetes.
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5
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van Dam M, de Jong BA, Willemse EAJ, Nauta IM, Huiskamp M, Klein M, Moraal B, de Geus-Driessen S, Geurts JJG, Uitdehaag BMJ, Teunissen CE, Hulst HE. A multimodal marker for cognitive functioning in multiple sclerosis: the role of NfL, GFAP and conventional MRI in predicting cognitive functioning in a prospective clinical cohort. J Neurol 2023:10.1007/s00415-023-11676-4. [PMID: 37101095 DOI: 10.1007/s00415-023-11676-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Cognitive impairment in people with MS (PwMS) has primarily been investigated using conventional imaging markers or fluid biomarkers of neurodegeneration separately. However, the single use of these markers do only partially explain the large heterogeneity found in PwMS. OBJECTIVE To investigate the use of multimodal (bio)markers: i.e., serum and cerebrospinal fluid (CSF) levels of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) and conventional imaging markers in predicting cognitive functioning in PwMS. METHODS Eighty-two PwMS (56 females, disease duration = 14 ± 9 years) underwent neuropsychological and neurological examination, structural magnetic resonance imaging, blood sampling and lumbar puncture. PwMS were classified as cognitively impaired (CI) if scoring ≥ 1.5SD below normative scores on ≥ 20% of test scores. Otherwise, PwMS were defined as cognitively preserved (CP). Association between fluid and imaging (bio)markers were investigated, as well as binary logistics regression to predict cognitive status. Finally, a multimodal marker was calculated using statistically important predictors of cognitive status. RESULTS Only higher NfL levels (in serum and CSF) correlated with worse processing speed (r = - 0.286, p = 0.012 and r = - 0.364, p = 0.007, respectively). sNfL added unique variance in the prediction of cognitive status on top of grey matter volume (NGMV), p = 0.002). A multimodal marker of NGMV and sNfL yielded most promising results in predicting cognitive status (sensitivity = 85%, specificity = 58%). CONCLUSION Fluid and imaging (bio)markers reflect different aspects of neurodegeneration and cannot be used interchangeably as markers for cognitive functioning in PwMS. The use of a multimodal marker, i.e., the combination of grey matter volume and sNfL, seems most promising for detecting cognitive deficits in MS.
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Affiliation(s)
- Maureen van Dam
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
| | - Brigit A de Jong
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Eline A J Willemse
- Neurochemistry Lab, Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
- Neurology Clinic and Policlinic, Departments of Head, Spine and Neuromedicine, Biomedicine and Clinical Research, Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ilse M Nauta
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Marijn Huiskamp
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Martin Klein
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Bastiaan Moraal
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Sanne de Geus-Driessen
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Jeroen J G Geurts
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Lab, Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Hanneke E Hulst
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Wassenaarseweg 52, Leiden, The Netherlands
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Sen MK, Hossain MJ, Mahns DA, Brew BJ. Validity of serum neurofilament light chain as a prognostic biomarker of disease activity in multiple sclerosis. J Neurol 2023; 270:1908-1930. [PMID: 36520240 DOI: 10.1007/s00415-022-11507-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
Multiple sclerosis (MS) is a chronic demyelinating and neuroinflammatory disease of the human central nervous system with complex pathoetiology, heterogeneous presentations and an unpredictable course of disease progression. There remains an urgent need to identify and validate a biomarker that can reliably predict the initiation and progression of MS as well as identify patient responses to disease-modifying treatments/therapies (DMTs). Studies exploring biomarkers in MS and other neurodegenerative diseases currently focus mainly on cerebrospinal fluid (CSF) analyses, which are invasive and impractical to perform on a repeated basis. Recent studies, replacing CSF with peripheral blood samples, have revealed that the elevation of serum neurofilament light chain (sNfL) in the clinical stages of MS is, potentially, an ideal prognostic biomarker for predicting disease progression and for possibly guiding treatment decisions. However, there are unresolved factors (the definition of abnormal values of sNfL concentration, the standardisation of measurement and the amount of change in sNfL concentration that is significant) that are preventing its use as a biomarker in routine clinical practice for MS. This updated review critiques these recent findings and highlights areas for focussed work to facilitate the use of sNfL as a prognostic biomarker in MS management.
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Affiliation(s)
- Monokesh K Sen
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
- Peter Duncan Neuroscience Research Unit, St Vincent's Centre for Applied Medical Research, Darlinghurst, Sydney, 2010, Australia
- Charles Perkins Centre, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Md Jakir Hossain
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - David A Mahns
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Bruce J Brew
- Peter Duncan Neuroscience Research Unit, St Vincent's Centre for Applied Medical Research, Darlinghurst, Sydney, 2010, Australia.
- School of Biomedical Sciences, UNSW Sydney, Sydney, NSW, 2052, Australia.
- Department of Neurology, St Vincent's Hospital, Darlinghurst, 2010, Australia.
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Rademacher TD, Meuth SG, Wiendl H, Johnen A, Landmeyer NC. Molecular biomarkers and cognitive impairment in multiple sclerosis: State of the field, limitations, and future direction - A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 146:105035. [PMID: 36608917 DOI: 10.1016/j.neubiorev.2023.105035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Multiple sclerosis (MS) is associated with cognitive impairment (CI) such as slowed information processing speed (IPS). Currently, no immunocellular or molecular markers have been established in cerebrospinal fluid and serum analysis as surrogate biomarkers with diagnostic or predictive value for the development of CI. This systematic review and meta-analysis aims to sum up the evidence regarding currently discussed markers for CI in MS. METHODS A literature search was conducted on molecular biomarkers of CI in MS, such as neurofilament light chain, chitinases, and vitamin D. RESULTS 5543 publications were screened, of which 77 entered the systematic review. 13 studies were included in the meta-analysis. Neurofilament light chain (CSF: rp = -0.294, p = 0.003; serum: rp = -0.137, p = 0.001) and serum levels of vitamin D (rp = 0.190, p = 0.014) were associated with IPS outcomes. CONCLUSIONS Neurofilament light chain and vitamin D are promising biomarkers to track impairments in IPS in MS. Further longitudinal research is needed to establish the use of molecular biomarkers to monitor cognitive decline.
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Affiliation(s)
| | - Sven G Meuth
- Department of Neurology, University Hospital Düsseldorf, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital Münster, Germany
| | - Andreas Johnen
- Department of Neurology, University Hospital Münster, Germany
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Sá MJ, Basílio C, Capela C, Cerqueira JJ, Mendes I, Morganho A, Correia de Sá J, Salgado V, Martins Silva A, Vale J, Sousa L. Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel. ACTA MEDICA PORT 2023; 36:167-173. [PMID: 36735763 DOI: 10.20344/amp.18543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/24/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Multiple sclerosis is a disease with a heterogeneous evolution. The early identification of secondary progressive multiple sclerosis is a clinical challenge, which would benefit from the definition of biomarkers and diagnostic tools applicable in the transition phase from relapsing-remitting multiple sclerosis to secondary progressive multiple sclerosis. We aimed to reach a Portuguese national consensus on the monitoring of patients with multiple sclerosis and on the more relevant clinical variables for the early identification of its progression. MATERIAL AND METHODS A Delphi panel which included eleven Portuguese Neurologists participated in two rounds of questions between July and August of 2021. In the first round, 39 questions which belonged to the functional, cognitive, imaging, biomarkers and additional evaluations were included. Questions for which no consensus was obtained in the first round (less than 80% of agreement), were appraised by the panel during the second round. RESULTS The response rate was 100% in both rounds and consensus was reached for a total of 33 questions (84.6%). Consensus was reached for monitoring time, evaluation scales and clinical variables such as the degree of brain atrophy and mobility reduction, changes suggestive of secondary progressive multiple sclerosis. Additionally, digital devices were considered tools with potential to identify disease progression. Most questions for which no consensus was obtained referred to the cognitive assessment and the remaining referred to both functional and imaging domains. CONCLUSION Consensus was obtained for the determination of the monitorization interval and for most of the clinical variables. Most questions that did not reach consensus were related with the confirmation of progression taking into account only one test/domain, reinforcing the multifactorial nature of multiple sclerosis.
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Affiliation(s)
- Maria José Sá
- Serviço de Neurologia. Centro Hospitalar e Universitário de São João. Porto. Portugal
| | - Carlos Basílio
- Serviço de Neurologia. Centro Hospitalar Universitário do Algarve. Faro. Portugal
| | - Carlos Capela
- Serviço de Neurologia. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal
| | | | - Irene Mendes
- Serviço de Neurologia. Hospital Garcia de Orta. Almada. Portugal
| | - Armando Morganho
- Serviço de Neurologia. Hospital Dr. Nélio Mendonça. Funchal. Portugal
| | - João Correia de Sá
- Serviço de Neurologia. Hospital de Santa Maria. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Vasco Salgado
- Serviço de Neurologia. Hospital Professor Doutor Fernando Fonseca. Amadora. Portugal
| | - Ana Martins Silva
- Serviço de Neurologia. Centro Hospitalar Universitário do Porto. Porto. Portugal
| | - José Vale
- Serviço de Neurologia. Hospital Beatriz Ângelo. Loures. Portugal
| | - Lívia Sousa
- Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
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Rosenstein I, Axelsson M, Novakova L, Rasch S, Blennow K, Zetterberg H, Lycke J. High levels of kappa free light chain synthesis predict cognitive decline in relapsing-remitting multiple sclerosis. Front Immunol 2023; 14:1106028. [PMID: 36742305 PMCID: PMC9896185 DOI: 10.3389/fimmu.2023.1106028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
Background Evolving evidence suggests that measurement of cerebrospinal fluid (CSF) kappa free light chain (KFLC) synthesis has high diagnostic sensitivity and specificity for multiple sclerosis (MS), but its prognostic ability is less investigated. The usefulness of KFLC in predicting cognitive impairment (CI) is still unknown. Methods In a monocentric longitudinal retrospecitve cohort study, KFLC-index ([CSF KFLC/serum KFLC]/[CSF albumin/serum albumin]) measured by latex-enhanced immunonephelometry was prospectively determined as part of the diagnostic workup in patients with early relapsing-remitting MS (RRMS, n=77). The ability of KFLC-index to predict information processing speed (IPS) worsening as assessed with the symbol digit modalities test (SDMT) was investigated in univariable and multivariable models. Results In patients with KFLC-index>100 (n=31), 11 subjects (35.5%) showed reduced SDMT scores by ≥8 points at follow-up (mean follow-up time 7.3 ± 2.6 years), compared with their baseline scores (p=0.01). Baseline KFLC-index>100 was strongly associated with a higher hazard of SDMT score reduction at follow-up (adjusted hazard ratio 10.5, 95% confidence interval 2.2-50.8, p=0.003; median time to SDMT reduction 7 years). Conclusion Intrathecal KFLC synthesis has become an attractive diagnostic tool for MS. We show for the first time that in a real-world setting of early RRMS, KFLC-index predicted cognitive decline. Whether this predictive ability of KFLC-index also concerns other cognitive domains than IPS, warrants further investigations.
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Affiliation(s)
- Igal Rosenstein
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,*Correspondence: Igal Rosenstein,
| | - Markus Axelsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lenka Novakova
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sofia Rasch
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden,United Kingdom (UK) Dementia Research Institute at University College London (UCL), London, United Kingdom,Department of Neurodegenerative Disease, University College London (UCL) Queen Square Institute of Neurology, London, United Kingdom,Hong Kong Centre for Neurodegenerative Diseases, Hong Kong SAR, China,Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Jan Lycke
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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10
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Heiskanen M, Jääskeläinen O, Manninen E, Das Gupta S, Andrade P, Ciszek R, Gröhn O, Herukka SK, Puhakka N, Pitkänen A. Plasma Neurofilament Light Chain (NF-L) Is a Prognostic Biomarker for Cortical Damage Evolution but Not for Cognitive Impairment or Epileptogenesis Following Experimental TBI. Int J Mol Sci 2022; 23:ijms232315208. [PMID: 36499527 PMCID: PMC9736117 DOI: 10.3390/ijms232315208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/08/2022] Open
Abstract
Plasma neurofilament light chain (NF-L) levels were assessed as a diagnostic biomarker for traumatic brain injury (TBI) and as a prognostic biomarker for somatomotor recovery, cognitive decline, and epileptogenesis. Rats with severe TBI induced by lateral fluid-percussion injury (n = 26, 13 with and 13 without epilepsy) or sham-operation (n = 8) were studied. During a 6-month follow-up, rats underwent magnetic resonance imaging (MRI) (day (D) 2, D7, and D21), composite neuroscore (D2, D6, and D14), Morris-water maze (D35−D39), and a 1-month-long video-electroencephalogram to detect unprovoked seizures during the 6th month. Plasma NF-L levels were assessed using a single-molecule assay at baseline (i.e., naïve animals) and on D2, D9, and D178 after TBI or a sham operation. Plasma NF-L levels were 483-fold higher on D2 (5072.0 ± 2007.0 pg/mL), 89-fold higher on D9 (930.3 ± 306.4 pg/mL), and 3-fold higher on D176 32.2 ± 8.9 pg/mL after TBI compared with baseline (10.5 ± 2.6 pg/mL; all p < 0.001). Plasma NF-L levels distinguished TBI rats from naïve animals at all time-points examined (area under the curve [AUC] 1.0, p < 0.001), and from sham-operated controls on D2 (AUC 1.0, p < 0.001). Plasma NF-L increases on D2 were associated with somatomotor impairment severity (ρ = −0.480, p < 0.05) and the cortical lesion extent in MRI (ρ = 0.401, p < 0.05). Plasma NF-L increases on D2 or D9 were associated with the cortical lesion extent in histologic sections at 6 months post-injury (ρ = 0.437 for D2; ρ = 0.393 for D9, p < 0.05). Plasma NF-L levels, however, did not predict somatomotor recovery, cognitive decline, or epileptogenesis (p > 0.05). Plasma NF-L levels represent a promising noninvasive translational diagnostic biomarker for acute TBI and a prognostic biomarker for post-injury somatomotor impairment and long-term structural brain damage.
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Affiliation(s)
- Mette Heiskanen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Olli Jääskeläinen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Eppu Manninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Shalini Das Gupta
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Pedro Andrade
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Robert Ciszek
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Olli Gröhn
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, P.O. Box 1777, 70211 Kuopio, Finland
| | - Noora Puhakka
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Asla Pitkänen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
- Correspondence:
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11
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Scaroni F, Visconte C, Serpente M, Golia MT, Gabrielli M, Huiskamp M, Hulst HE, Carandini T, De Riz M, Pietroboni A, Rotondo E, Scarpini E, Galimberti D, Teunissen CE, van Dam M, de Jong BA, Fenoglio C, Verderio C. miR-150-5p and let-7b-5p in Blood Myeloid Extracellular Vesicles Track Cognitive Symptoms in Patients with Multiple Sclerosis. Cells 2022; 11:cells11091551. [PMID: 35563859 PMCID: PMC9104242 DOI: 10.3390/cells11091551] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023] Open
Abstract
Cognitive deficits strongly affect the quality of life of patients with multiple sclerosis (MS). However, no cognitive MS biomarkers are currently available. Extracellular vesicles (EVs) contain markers of parental cells and are able to pass from the brain into blood, representing a source of disease biomarkers. The aim of this study was to investigate whether small non-coding microRNAs (miRNAs) targeting synaptic genes and packaged in plasma EVs may reflect cognitive deficits in MS patients. Total EVs were precipitated by Exoquick from the plasma of twenty-six cognitively preserved (CP) and twenty-three cognitively impaired (CI) MS patients belonging to two independent cohorts. Myeloid EVs were extracted by affinity capture from total EVs using Isolectin B4 (IB4). Fourteen miRNAs targeting synaptic genes were selected and measured by RT-PCR in both total and myeloid EVs. Myeloid EVs from CI patients expressed higher levels of miR-150-5p and lower levels of let-7b-5p compared to CP patients. Stratification for progressive MS (PMS) and relapsing-remitting MS (RRMS) and correlation with clinical parameters suggested that these alterations might be attributable to cognitive deficits rather than disease progression. This study identifies miR-150-5p and let-7b-5p packaged in blood myeloid EVs as possible biomarkers for cognitive deficits in MS.
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Affiliation(s)
- Federica Scaroni
- Institute of Neuroscience, CNR, Via Follereau 3, 20854 Vedano al Lambro, Italy; (F.S.); (M.T.G.); (M.G.)
| | - Caterina Visconte
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via F. Sforza 35, 20122 Milan, Italy; (C.V.); (E.S.); (D.G.)
- Centro Dino Ferrari, University of Milan, 20122 Milan, Italy; (M.S.); (T.C.); (M.D.R.); (A.P.); (E.R.)
| | - Maria Serpente
- Centro Dino Ferrari, University of Milan, 20122 Milan, Italy; (M.S.); (T.C.); (M.D.R.); (A.P.); (E.R.)
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, 20122 Milan, Italy
| | - Maria Teresa Golia
- Institute of Neuroscience, CNR, Via Follereau 3, 20854 Vedano al Lambro, Italy; (F.S.); (M.T.G.); (M.G.)
| | - Martina Gabrielli
- Institute of Neuroscience, CNR, Via Follereau 3, 20854 Vedano al Lambro, Italy; (F.S.); (M.T.G.); (M.G.)
| | - Marijn Huiskamp
- MS Center Amsterdam, Amsterdam Neuroscience, Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam UMC, De Boelelaan 1117, 1081 Amsterdam, The Netherlands; (M.H.); (M.v.D.)
| | - Hanneke E. Hulst
- Health-, Medical- and Neuropsychology Unit, Institute of Psychology, Leiden University, 2300 Leiden, The Netherlands;
| | - Tiziana Carandini
- Centro Dino Ferrari, University of Milan, 20122 Milan, Italy; (M.S.); (T.C.); (M.D.R.); (A.P.); (E.R.)
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, 20122 Milan, Italy
| | - Milena De Riz
- Centro Dino Ferrari, University of Milan, 20122 Milan, Italy; (M.S.); (T.C.); (M.D.R.); (A.P.); (E.R.)
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, 20122 Milan, Italy
| | - Anna Pietroboni
- Centro Dino Ferrari, University of Milan, 20122 Milan, Italy; (M.S.); (T.C.); (M.D.R.); (A.P.); (E.R.)
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, 20122 Milan, Italy
| | - Emanuela Rotondo
- Centro Dino Ferrari, University of Milan, 20122 Milan, Italy; (M.S.); (T.C.); (M.D.R.); (A.P.); (E.R.)
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, 20122 Milan, Italy
| | - Elio Scarpini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via F. Sforza 35, 20122 Milan, Italy; (C.V.); (E.S.); (D.G.)
- Centro Dino Ferrari, University of Milan, 20122 Milan, Italy; (M.S.); (T.C.); (M.D.R.); (A.P.); (E.R.)
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, 20122 Milan, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via F. Sforza 35, 20122 Milan, Italy; (C.V.); (E.S.); (D.G.)
- Centro Dino Ferrari, University of Milan, 20122 Milan, Italy; (M.S.); (T.C.); (M.D.R.); (A.P.); (E.R.)
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, 20122 Milan, Italy
| | - Charlotte E. Teunissen
- MS Center Amsterdam, Amsterdam Neuroscience, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 Amsterdam, The Netherlands; (C.E.T.); (B.A.d.J.)
| | - Maureen van Dam
- MS Center Amsterdam, Amsterdam Neuroscience, Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam UMC, De Boelelaan 1117, 1081 Amsterdam, The Netherlands; (M.H.); (M.v.D.)
| | - Brigit A. de Jong
- MS Center Amsterdam, Amsterdam Neuroscience, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 Amsterdam, The Netherlands; (C.E.T.); (B.A.d.J.)
| | - Chiara Fenoglio
- MS Center Amsterdam, Amsterdam Neuroscience, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 Amsterdam, The Netherlands; (C.E.T.); (B.A.d.J.)
- Department of Neuropathology and Transplantation, University of Milan, Via F. Sforza 35, 20122 Milan, Italy
- Correspondence: (C.F.); (C.V.); Tel.: +39-0264488386 (C.V.)
| | - Claudia Verderio
- Institute of Neuroscience, CNR, Via Follereau 3, 20854 Vedano al Lambro, Italy; (F.S.); (M.T.G.); (M.G.)
- Correspondence: (C.F.); (C.V.); Tel.: +39-0264488386 (C.V.)
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12
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Virgilio E, Vecchio D, Crespi I, Puricelli C, Barbero P, Galli G, Cantello R, Dianzani U, Comi C. Cerebrospinal fluid biomarkers and cognitive functions at multiple sclerosis diagnosis. J Neurol 2022; 269:3249-3257. [PMID: 35088141 DOI: 10.1007/s00415-021-10945-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023]
Abstract
Cognitive impairment (CI) is a frequent and disabling symptom in Multiple Sclerosis (MS). Axonal damage may contribute to CI development from early stages. Nevertheless, no biomarkers are at the moment available to track CI in MS patients. We aimed to explore the correlation of cerebrospinal fluid (CSF) axonal biomarkers, in particular: light-chain neurofilaments (NFL), Tau, and Beta-amyloid protein (Abeta) in MS patients with CI at the diagnosis. 62 newly diagnosed MS patients were enrolled, and cognition was evaluated using the Brief International Cognitive Assessment for MS (BICAMS) battery. CSF NFL, Abeta, and Tau levels were determined with commercial ELISA. Patients with CI (45.1%) did not differ for demographic, clinical, and MRI characteristics (except for lower educational level), but they displayed greater neurodegeneration, exhibiting higher mean CSF Tau protein (162.1 ± 52.96 pg/ml versus 132.2 ± 63.86 pg/ml p:0.03). No differences were observed for Abeta and NFL. The number of impaired tests and Tau were significantly correlated (r:0.32 p:0.01). Tau was higher in particular in patients with slowed information processing speed (IPS) (p:0.006) and a linear regression analysis accounting for EDSS, MRI, and MS subtype confirmed Tau as a weak predictor of IPS and cognitive impairment. In conclusion, CI has an important burden on the quality of life of MS patients and should be looked for even at diagnosis. Axonal damage biomarkers, and in particular Tau, seem to reflect cognition impairment in the early stages.
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Affiliation(s)
- Eleonora Virgilio
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy. .,Phd Program in Medical Sciences and Biotechnologies, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy. .,Department of Translational Medicine, Neurology Unit, S. Andrea Hospital, University of Piemonte Orientale, Vercelli, Italy.
| | - Domizia Vecchio
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy.,Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy
| | - Ilaria Crespi
- Department of Health Sciences, Clinical Biochemistry, University of Piemonte Orientale, Novara, Italy
| | - Chiara Puricelli
- Department of Health Sciences, Clinical Biochemistry, University of Piemonte Orientale, Novara, Italy
| | - Paolo Barbero
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy
| | - Giulia Galli
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy
| | - Roberto Cantello
- Department of Translational Medicine, Neurology Unit, Maggiore Della Carità Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy
| | - Umberto Dianzani
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy.,Department of Health Sciences, Clinical Biochemistry, University of Piemonte Orientale, Novara, Italy
| | - Cristoforo Comi
- Department of Translational Medicine, Neurology Unit, S. Andrea Hospital, University of Piemonte Orientale, Vercelli, Italy.,Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy
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13
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Dal-Bianco A, Schranzer R, Grabner G, Lanzinger M, Kolbrink S, Pusswald G, Altmann P, Ponleitner M, Weber M, Kornek B, Zebenholzer K, Schmied C, Berger T, Lassmann H, Trattnig S, Hametner S, Leutmezer F, Rommer P. Iron Rims in Patients With Multiple Sclerosis as Neurodegenerative Marker? A 7-Tesla Magnetic Resonance Study. Front Neurol 2022; 12:632749. [PMID: 34992573 PMCID: PMC8724313 DOI: 10.3389/fneur.2021.632749] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system, characterized by inflammatory-driven demyelination. Symptoms in MS manifest as both physical and neuropsychological deficits. With time, inflammation is accompanied by neurodegeneration, indicated by brain volume loss on an MRI. Here, we combined clinical, imaging, and serum biomarkers in patients with iron rim lesions (IRLs), which lead to severe tissue destruction and thus contribute to the accumulation of clinical disability. Objectives: Subcortical atrophy and ventricular enlargement using an automatic segmentation pipeline for 7 Tesla (T) MRI, serum neurofilament light chain (sNfL) levels, and neuropsychological performance in patients with MS with IRLs and non-IRLs were assessed. Methods: In total 29 patients with MS [15 women, 24 relapsing-remitting multiple sclerosis (RRMS), and five secondary-progressive multiple sclerosis (SPMS)] aged 38 (22–69) years with an Expanded Disability Status Score of 2 (0–8) and a disease duration of 11 (5–40) years underwent neurological and neuropsychological examinations. Volumes of lesions, subcortical structures, and lateral ventricles on 7-T MRI (SWI, FLAIR, and MP2RAGE, 3D Segmentation Software) and sNfL concentrations using the Simoa SR-X Analyzer in IRL and non-IRL patients were assessed. Results: (1) Iron rim lesions patients had a higher FLAIR lesion count (p = 0.047). Patients with higher MP2Rage lesion volume exhibited more IRLs (p <0.014) and showed poorer performance in the information processing speed tested within 1 year using the Symbol Digit Modalities Test (SDMT) (p <0.047). (2) Within 3 years, patients showed atrophy of the thalamus (p = 0.021) and putamen (p = 0.043) and enlargement of the lateral ventricles (p = 0.012). At baseline and after 3 years, thalamic volumes were lower in IRLs than in non-IRL patients (p = 0.045). (3) At baseline, IRL patients had higher sNfL concentrations (p = 0.028). Higher sNfL concentrations were associated with poorer SDMT (p = 0.004), regardless of IRL presence. (4) IRL and non-IRL patients showed no significant difference in the neuropsychological performance within 1 year. Conclusions: Compared with non-IRL patients, IRL patients had higher FLAIR lesion counts, smaller thalamic volumes, and higher sNfL concentrations. Our pilot study combines IRL and sNfL, two biomarkers considered indicative for neurodegenerative processes. Our preliminary data underscore the reported destructive nature of IRLs.
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Affiliation(s)
| | - R Schranzer
- Department of Neurology, Vienna, Austria.,Department of Medical Engineering, Carinthia University of Applied Sciences, Klagenfurt, Austria
| | - G Grabner
- Department of Neurology, Vienna, Austria.,Department of Medical Engineering, Carinthia University of Applied Sciences, Klagenfurt, Austria
| | | | - S Kolbrink
- Department of Neurology, Vienna, Austria
| | - G Pusswald
- Department of Neurology, Vienna, Austria
| | - P Altmann
- Department of Neurology, Vienna, Austria
| | | | - M Weber
- Department of Biomedical Imaging and Image-Guided Therapy, High Field Magnetic Resonance Centre, Vienna, Austria
| | - B Kornek
- Department of Neurology, Vienna, Austria
| | | | - C Schmied
- Department of Neurology, Vienna, Austria
| | - T Berger
- Department of Neurology, Vienna, Austria
| | - H Lassmann
- Department of Neuroimmunology, Center for Brain Research, Vienna, Austria
| | - S Trattnig
- Department of Biomedical Imaging and Image-Guided Therapy, High Field Magnetic Resonance Centre, Vienna, Austria
| | - S Hametner
- Department of Neurology, Vienna, Austria.,Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | | | - P Rommer
- Department of Neurology, Vienna, Austria
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14
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Abstract
PURPOSE OF REVIEW Converging evidence suggest axonal damage is implicated in depression and cognitive function. Neurofilament light protein, measured within serum and cerebrospinal fluid, may be a biomarker of axonal damage. This article examines the emerging evidence implicating neurofilament light protein in depression and cognitive function. RECENT FINDINGS Preliminary cross-sectional and case-control studies in cohorts with depression have yielded inconsistent results regarding the association between neurofilament light protein and symptomatology. However, these studies had methodological limitations, requiring further investigation. Importantly, neurofilament light protein concentrations may be a marker of progression of cognitive decline and may be associated with cognitive performance within cognitively intact cohorts. SUMMARY Axonal damage is implicated in the neuropathology of depression and cognitive dysfunction. Consequently, neurofilament light protein is an emerging biomarker with potential in depression and cognitive function. Results are more consistent for cognition, requiring more research to assess neurofilament light protein in depression as well as other psychiatric disorders. Future longitudinal studies are necessary to determine whether neurofilament light protein can predict the onset and progression of depression and measure the effectiveness of potential psychiatric interventions and medications.
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15
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Chen MH, Liu YL, Kuo HW, Tsai SJ, Hsu JW, Huang KL, Tu PC, Bai YM. Neurofilament Light Chain Is a Novel Biomarker for Major Depression and Related Executive Dysfunction. Int J Neuropsychopharmacol 2021; 25:99-105. [PMID: 34637515 PMCID: PMC8832224 DOI: 10.1093/ijnp/pyab068] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/20/2021] [Accepted: 10/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Evidence suggests that major depressive disorder is related to neuroaxonal injury and that neurofilament light chain (NfL) is a biomarker of neuroaxonal injury. In addition, proinflammatory cytokines have been reported to be associated with major depression and neuroaxonal injury. METHODS Forty patients with major depression and 40 age- and sex-matched healthy control participants were enrolled for the measurement of NfL and proinflammatory cytokines and assessment of executive function. General linear models were used to examine the association between NfL levels, proinflammatory cytokine levels, and executive function. RESULTS Patients with major depressive disorder exhibited significantly higher NfL levels (P = .007) than the control participants. NfL levels were positively related to log-transformed levels of tumor necrosis factor-α (P = .004). Higher levels of NfL (P = .002) and tumor necrosis factor-α (P = .013) were associated with greater deficits in executive function. DISCUSSION NfL was a novel biomarker for major depressive disorder and related executive dysfunction. Further studies are necessary to elucidate the role of NfL in the pathophysiology of major depression and related cognitive impairment.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Hsiang-Wei Kuo
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Correspondence: Ya-Mei Bai, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan ()
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16
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Ramani S, Berard JA, Walker LAS. The relationship between neurofilament light chain and cognition in neurological disorders: A scoping review. J Neurol Sci 2020; 420:117229. [PMID: 33243431 DOI: 10.1016/j.jns.2020.117229] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/29/2020] [Accepted: 11/16/2020] [Indexed: 12/19/2022]
Abstract
Neurofilament light chain (NfL) is an emerging biomarker of neural degeneration. NfL is an integral component of axons and is released into the bloodstream and cerebrospinal fluid during neurodegeneration; hence it can be used to monitor disease progression. Given that several neurological disorders are accompanied by cognitive decline, recent literature has investigated the relationship between NfL levels and cognition. The objective of this scoping review was to determine whether a consistent relationship between NfL and cognition exists in the context of variable degrees of neurodegeneration present across several neurological disorders. Four electronic databases were searched for relevant articles and 160 articles were initially identified. After article screening, 37 studies met the final inclusion criteria. Studies were then qualitatively synthesized to determine the relationship between NfL and cognition across a variety of neurological disorders. The large majority of studies found that NfL levels are inversely correlated with cognition, such that higher NfL levels are associated with poorer cognition. This relationship was not universal, however, and this discrepancy was speculated to be due to the nature of the neurological disorder, individual differences between participants, or methodological inconsistencies. Further study is required, and associated recommendations were proposed for the design of future investigations.
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Affiliation(s)
| | | | - Lisa A S Walker
- The Ottawa Hospital Research Institute, Ottawa, Canada; The University of Ottawa Brain and Mind Research Institute, Ottawa, Canada; Carleton University, Ottawa, Canada
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Blood Neurofilament Light Chain: The Neurologist's Troponin? Biomedicines 2020; 8:biomedicines8110523. [PMID: 33233404 PMCID: PMC7700209 DOI: 10.3390/biomedicines8110523] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/19/2022] Open
Abstract
Blood neurofilament light chain (NfL) is a marker of neuro-axonal injury showing promising associations with outcomes of interest in several neurological conditions. Although initially discovered and investigated in the cerebrospinal fluid (CSF), the recent development of ultrasensitive digital immunoassay technologies has enabled reliable detection in serum/plasma, obviating the need for invasive lumbar punctures for longitudinal assessment. The most evidence for utility relates to multiple sclerosis (MS) where it serves as an objective measure of both the inflammatory and degenerative pathologies that characterise this disease. In this review, we summarise the physiology and pathophysiology of neurofilaments before focusing on the technological advancements that have enabled reliable quantification of NfL in blood. As the test case for clinical translation, we then highlight important recent developments linking blood NfL levels to outcomes in MS and the next steps to be overcome before this test is adopted on a routine clinical basis.
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Okan G, Baki AM, Yorulmaz E, Doğru-Abbasoğlu S, Vural P. A preliminary study about neurofilament light chain and tau protein levels in psoriasis: Correlation with disease severity. J Clin Lab Anal 2020; 35:e23564. [PMID: 32896023 PMCID: PMC7843295 DOI: 10.1002/jcla.23564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/26/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Studies investigating cognitive dysfunction in psoriatic patients remain inconclusive. OBJECTIVE To investigate the risk of cognitive decline in plaque-type psoriasis patients. METHODS Serum neurofilament light chain (NFL) and tau protein concentrations in 45 patients with plaque-type psoriasis and forty-five healthy controls were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS Mean homeostasis model assessment (HOMA-IR) values (6.82 vs 3.25) and serum levels of insulin (28.19 vs 15.71), NFL (5.74 vs 1.98), and tau (348.17 vs 207.30) in patients with psoriasis were found to be significantly higher than those of in healthy controls. There was a significant positive correlation between NFL and tau (r = .257, P = .015). There was significant correlation between NFL, tau and PASI (r = .310, P = .040) and (r = .383, P = .010), respectively. Significant correlations between NFL and insulin, TC, HDL-C, TG, VLDL-C, and BMI were found. NFL (9.38 vs 3.08) and tau (439.28 vs 281.58) concentrations and PASI values (23.94 vs 14.18) in patients with disease onset before 40 years were significantly higher than that of the patients with disease onset after 40 years. C-reactive protein (CRP) was significantly correlated with BMI (r = .449, P < .001), LDL-C (r = .240, P = .026), TG (r = .244, P = .024), and VLDL-C (r = .241, P = .025) in patients with psoriasis. CONCLUSIONS Increased serum NFL and tau protein levels and the presence of positive correlations between NFL, tau protein and PASI score show cognitive decline risk may be higher in moderate-to-severe psoriasis.
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Affiliation(s)
- Gokhan Okan
- Department of Dermatology, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Adile Merve Baki
- Department of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Eda Yorulmaz
- Department of Biochemistry, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Semra Doğru-Abbasoğlu
- Department of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Pervin Vural
- Department of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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