Elevated levels of serum neurofilament light chain (NfL), a neuronal protein that increases with neuroaxonal injury, may serve as an early biomarker for disability progression in multiple sclerosis (MS), according to a recent cohort study published in JAMA Neurology.

Investigators analyzed data from 1899 participants and 12,807 visits across two long-term observational cohorts—the Expression, Proteomics, Imaging, Clinical (EPIC) study and the Swiss Multiple Sclerosis Cohort (SMSC)—and used mixed linear and Cox regression models to determine whether elevated NfL levels were associated with future confirmed disability worsening (CDW).

Their findings showed that increased NfL levels corresponded with a 70% to 91% higher risk of relapse-associated CDW (CDW-R) events within approximately 1 year and a 40% to 49% higher risk of relapse-independent CDW (CDW-NR) events within 1–2 years. The elevated NfL levels suggest ongoing neuroaxonal damage preceding clinical symptoms, underscoring the value of NfL as a predictive biomarker.

This insight could enhance the management of MS by enabling earlier detection of disease activity and providing a window for the timely initiation of treatment strategies aimed at mitigating long-term disability.

Source: Abdelhak A, Benkert P, Schaedelin S, et al. Neurofilament Light Chain Elevation and Disability Progression in Multiple Sclerosis. JAMA Neurol. 2023;80(12):1317–1325. doi:10.1001/jamaneurol.2023.3997