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Rival M, Thouvenot E, Du Trieu de Terdonck L, Laurent-Chabalier S, Demattei C, Uygunoglu U, Castelnovo G, Cohen M, Okuda DT, Kantarci OH, Pelletier D, Azevedo C, Marin P, Lehmann S, Siva A, Mura T, Lebrun-Frenay C. Neurofilament Light Chain Levels Are Predictive of Clinical Conversion in Radiologically Isolated Syndrome. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 10:10/1/e200044. [PMID: 36280258 PMCID: PMC9621336 DOI: 10.1212/nxi.0000000000200044] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND OBJECTIVES To evaluate the predictive value of serum neurofilament light chain (sNfL) and CSF NfL (cNfL) in patients with radiologically isolated syndrome (RIS) for evidence of disease activity (EDA) and clinical conversion (CC). METHODS sNfL and cNfL were measured at RIS diagnosis by single-molecule array (Simoa). The risk of EDA and CC according to sNfL and cNfL was evaluated using the Kaplan-Meier analysis and multivariate Cox regression models including age, spinal cord (SC) or infratentorial lesions, oligoclonal bands, CSF chitinase 3-like protein 1, and CSF white blood cells. RESULTS Sixty-one patients with RIS were included. At diagnosis, sNfL and cNfL were correlated (Spearman r = 0.78, p < 0.001). During follow-up, 47 patients with RIS showed EDA and 36 patients showed CC (median time 12.6 months, 1-86). When compared with low levels, medium and high cNfL (>260 pg/mL) and sNfL (>5.0 pg/mL) levels were predictive of EDA (log rank, p < 0.01 and p = 0.02, respectively). Medium-high cNfL levels were predictive of CC (log rank, p < 0.01). In Cox regression models, cNfL and sNfL were independent factors of EDA, while SC lesions, cNfL, and sNfL were independent factors of CC. DISCUSSION cNfL >260 pg/mL and sNfL >5.0 pg/mL at diagnosis are independent predictive factors of EDA and CC in RIS. Although cNfL predicts disease activity better, sNfL is more accessible than cNfL and can be considered when a lumbar puncture is not performed. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that in people with radiologic isolated syndrome (RIS), initial serum and CSF NfL levels are associated with subsequent evidence of disease activity or clinical conversion.
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Affiliation(s)
- Manon Rival
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Eric Thouvenot
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France.
| | - Lucile Du Trieu de Terdonck
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Sabine Laurent-Chabalier
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Christophe Demattei
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Ugur Uygunoglu
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Giovanni Castelnovo
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Mikael Cohen
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Darin T Okuda
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Orhun H Kantarci
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Daniel Pelletier
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Christina Azevedo
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Philippe Marin
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Sylvain Lehmann
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Aksel Siva
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Thibault Mura
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Christine Lebrun-Frenay
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
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