MS is a heterogeneus disease,therefore it is important to determine the role of biomarkers measured at the time of diagnosis in predicting disease progression.

Thirty-three patients with RRMS were included in this study.Cerebrospinal fluid(CSF) and serum samples obtained at the time of diagnosis were analyzed for NfL,BDNF,RUNX1, and NRGN levels using enzyme-linked immunosorbent assay(ELISA).At the end of the follow-up period, white matter and cortical volumes were quantified on cranial MRI scans using the FreeSurfer software.

In RRMS patients, baseline CSF NfL levels showed a significant positive correlation with the number of relapses during the early follow-up period(first two years) after biomarker sampling(p=0.018).Patients who developed confirmed disability progression(CDP) during follow-up had significantly lower baseline CSF BDNF levels(p=0.001),with a cut-off value of 222.6 pg/mL.Baseline CSF BDNF levels were significantly negatively correlated with the number of relapses within the first two years,annualized relapse rate,and number of relapses within the first five years(p=0.048;p=0.012;p= 0.018).

Baseline CSF NfL levels had a statistically significant negative association with total white matter volume at follow-up(p=0.006),whereas baseline RUNX1 levels showed a positive association with total white matter volume(B=26.993;p=0.018).Moreover, patients who did not meet the NEDA-3 criteria at the second year exhibited significantly lower left and right cerebral white matter volumes compared with those who achieved NEDA-3(p=0.007;p=0.012).