Abstract Details

Title Impact of MRI Activity and Medical Comorbidities on Serum Neurofilament Light Chain in Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 20-004

Objective

Investigate comorbidities that may influence differential changes in sNfL among a clinical cohort of pwMS.

Background

Serum neurofilament light chain (sNfL) is a marker of axonal injury, yet some people with multiple sclerosis (pwMS) with enhancing MRI lesions show no sNfL elevation. Comorbidities including renal disease and diabetes mellitus may elevate sNfL, whereas obesity may decrease it, potentially confounding interpretation.

Design/Methods

Retrospective study of Mayo Clinic pwMS ≥20 years who underwent clinical sNfL testing using Simoa assay. Those with elevated sNfL for age, based on population reference data, were age- and sex-matched 1:1 to pwMS with normal sNfL. Obesity was defined as body mass index (BMI) ≥30 and renal disease as CKD stage 1 or worse. Continuous and binary variables were compared using Wilcoxon signed-rank and McNemar’s tests, respectively.

Results

169 pwMS with elevated sNfL compared to 169 age- and sex-matched pwMS with normal sNfL (median age at time of sNfL draw 39 years, 65% female). Median sNfL values were 23.1 pg/mL (elevated group) and 6.6 pg/mL (normal group). Patients with elevated sNfL were more likely to have enhancing lesions on brain MRI (67/132[51%] vs. 23/132[17]%, p<0.0001) or spinal cord MRI (22/74[30%] vs. 9/74[12%], p=0.01) within 3 months of sNfL draw. Positive predictive value of elevated sNfL for any enhancing lesion was 57% (sensitivity 72%), while negative predictive value of normal sNfL without enhancing lesion was 78% (specificity 64%). No differences were found in BMI (median elevated sNfL 27.7 vs. 29.0, p=0.22), obesity (65/167[39%] vs. 72/167[44%], p=0.43), renal disease (12/151[8%] vs. 16/151[11%], p=0.5), or diabetes (8/49[16%] vs. 6/49[12%], p=0.75).

Conclusions

In this age- and sex-matched clinical cohort, elevated sNfL was correlated with but only moderately predictive of active lesions on MRI. Comorbidities known to alter sNfL did not account for observed differences in NfL elevation.

Authors/Disclosures
Hira Chouhdry, MD PRESENTER	Ms. Chouhdry has nothing to disclose.
Katherine L. Schleiss, MPH	Ms. Schleiss has nothing to disclose.
Matthew R. Baker, PhD	Dr. Baker has nothing to disclose.
Pearse Morris, kjsdfkshd	Ms. Morris has nothing to disclose.
W. O. Tobin, PhD, MBBCh, BAO, FAAN (Mayo Clinic)	Dr. Tobin has received publishing royalties from a publication relating to health care.
Eoin P. Flanagan, MBBCh, FAAN (Mayo Clinic)	The institution of Dr. Flanagan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Flanagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pharmacy times. The institution of Dr. Flanagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Roche. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Merck. The institution of Dr. Flanagan has received research support from Roche. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has a non-compensated relationship as a Member of medical Advisory Board with The MOG Project that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Journal of The Neurologic Sciences that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Neuroimmunology Reports that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology, Neuroimmunology Neuroinflammation (N2) Journal that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology that is relevant to AAN interests or activities.
Orhun H. Kantarci, MD	Dr. Kantarci has nothing to disclose.
Mark Keegan, MD, FAAN (Mayo Clinic)	Dr. Keegan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Keegan has received publishing royalties from a publication relating to health care. Dr. Keegan has received publishing royalties from a publication relating to health care.
M. M. Paz Soldan, MD, PhD (Mayo Clinic)	Dr. Paz Soldan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Paz Soldan has received research support from National Institutes of Health. The institution of Dr. Paz Soldan has received research support from National Multiple Sclerosis Society. The institution of Dr. Paz Soldan has received research support from Western Institute for Biomedical Research. The institution of Dr. Paz Soldan has received research support from Biogen. The institution of Dr. Paz Soldan has received research support from Novartis. The institution of Dr. Paz Soldan has received research support from Clene Nanomedicine.
Sean J. Pittock, MD, FAAN (Mayo Clinic Dept of Neurology)	Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. The institution of Dr. Pittock has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from NIH. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received publishing royalties from a publication relating to health care.
Samantha Banks, MD	Dr. Banks has nothing to disclose.

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