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ACTRIMS 2022 | sNfL activity correlates with MS severity more significantly than cNfL

Ruturaj Masvekar, PhD, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, discusses a study that significantly indicates a greater correlation between serum neurofilament light (sNfL) activity and multiple sclerosis (MS) severity, than CSF neurofilament light (cNfL) and MS severity. Initially, it was the notion that cNfL was a superior biomarker than sNfL; cNfL is thought to be the source of sNfL. However, acquiring serum is a less invasive procedure – thus, researchers are adjusting to the conformance. Dr Masvekar follows to discuss how when trying to predict disease severity in MS, measured by MSSS, ARMSS, and MS-DSS – sNfL was a superior biomarker than cNfL. The hypothesis to support this inferred that the NfL released from the spinal cord (SC) or peripheral neurons, is directly released into the blood or serum – bypassing the CSF. This is suggested due to the severity measurements of MS having some physical activity components – which are mainly a result of SC or peripheral neural damage. To test the hypothesis, Dr Masvekar applied a linear regression model for cNfL vs. sNfL – dividing patients into two groups: those with higher sNfL compared to cNfL, and those with lower sNfL compared to cNfL. The residuals were then used to see if the individuals with greater levels of sNfL had more clinical and MRI SC injury-related outcomes – implying sNfL as a superior biomarker. More comparative sNfL vs. cNfL studies are required to further test the hypothesis. This interview took place at the ACTRIMS Forum 2022 in West Palm Beach, Florida.