Midtveisevaluering - Alok Bhan

Alok Bhan er tilknyttet Klinisk Institutt 1. Veiledere er Elisabeth Farbu, Guido Alves og Kjell-Morten Myhr.

PhD project
Nevrofilamenter i MS

Abstract
There is a lack of biomarkers to predict disease progression in multiple sclerosis (MS), but there is also increasing scientific evidence that the protein Neurofilament Light-chain (NfL) can be used as such a biomarker. The long-term prognostic abilities of NfL are still not well described.

In this study we examined a cohort of patients from Hordaland and the southern parts of Rogaland with newly diagnoses MS in the years from 1998 to 2000. The 44 patients identified underwent a lumbar puncture and routine blood tests at baseline and were subsequently followed for 10 years with clinical assessment and thorough MRI-examinations every five years.

We found that level of cerebrospinal NfL (CSF-NfL) at the time of diagnosis were associated with increasing EDSS throughout the 10 years of follow-up, and patients who converted from relapsing-remitting MS (RRMS) to secondary-progressive MS (SPMS) had a statistical significant higher median CSF-NfL (2122 vs 246 ng/L, p=0.01). We also found significant associations between baseline CSF-NfL and MRI-volumes over the time course, where CSF-NfL was negatively associated with subcortical, pallidum, putamen and thalamus volumes. We also found a significant interaction with time for subcortical, pallidum, putamen and hippocampus volumes, suggesting that higher level of CSF-NfL at time of diagnosis predicts faster volume loss over the subsequent 10 years.

We conclude that CSF-NfL at baseline predicts both clinical and radiological outcome over the following 10 years.