Neurofilament light chain as an indicator of exacerbation prior to clinical symptoms in multiple sclerosis

Abstract Background Biomarkers may be a sensitive measure of disease activity in patients with multiple sclerosis (pwMS). Objective A pwMS had a marked increase of neurofilament light chain (NfL) in CSF 9-weeks prior to a clinical exacerbation. Methods and results Brain MRI, CSF, EDSS were measured at baseline, 6 weeks and 28 weeks. The patient had an exacerbation at week 15 of study but the NfL measured at week 6 were found to show a nearly 3-fold increase of CSF NfL levels prior to symptoms when the NfL levels were later measured. Conclusion This is an example supporting the usefulness of NfL in monitoring disease activity in pwMS which may predict disease activity prior to a clinical exacerbation.