A study published in Neurology shows that a blood test may help predict worsening of multiple sclerosis (MS) likely to occur within the next year. The test can detect a neurofilament light (NfL) chain in an individual’s blood when nerve cells die.
The study found that participants with MS who had high levels of NfL were 40% to 70% more likely to have worsening disability during the next year than those with low levels.
Those with high protein levels were 50% more likely to reach a level of moderate disability that affected daily activities but not walking ability or significant disability that impaired walking but did not affect the ability to walk without help or rest for 500 meters.
A total of 525 people (16%) reached a moderate level of disability and 352 people (9%) reached a significant disability.
The study involved 4,385 participants with MS and 1,026 participants matched for age and gender who did not have MS.
The participants were followed to find out which individuals with MS had a worsening condition, and which reached continued increased levels of disability over 5 years. The research also observed whether people with high levels of the protein were more likely to develop worsening of disability, including secondary progressive MS.
“In a disease like MS that is so unpredictable and varies so much from one person to the next, having a noninvasive blood test like this could be very valuable, especially since treatments are most effective in the earliest stages of the disease,” said Ali Manouchehrinia, PhD, of the Karolinska Institute in Stockholm, Sweden. “These results suggest that elevated levels of these proteins measured early on in the course of the disease may help us to predict how the disease will develop and monitor how treatment is working. More research is needed before a blood test could be used routinely in the clinical setting, but our results are encouraging.”
Leeann B. Burton, MD, and Amanda C. Guidon, MD
Britany Klenofsky, MD, and Huma U. Sheikh, MD
Chia-Chun Chiang, MD, and Juliana VanderPluym, MD, FRCP, FAHS