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The following is a summary of “Role of serum neurofilament light (sNfL) as a biomarker in multiple sclerosis: insights from a systematic review,” published in the May 2025 issue of Journal of Neurology by Freedman et al. 

Researchers conducted a retrospective study to investigate the role of serum neurofilament light chain (sNfL) as a biomarker in managing multiple sclerosis (MS).  

They performed the review following the Cochrane Handbook for Systematic Reviews guidelines. A thorough search was performed across key biomedical databases, including EMBASE ^®, MEDLINE ^®, MEDLINE^® -In-Process, and all Evidence-Based Medicine (EBM) Reviews databases, to find studies linking sNfL with MS disease activity. Additional data were gathered by hand-searching major conference proceedings and gray literature.  

The results showed that after screening 1,831 records, 75 studies from 180 publications were included. These studies consistently linked higher sNfL levels to an increased risk of relapses within 2 years and progression of MS. Elevated levels were also associated with a greater chance of gadolinium-enhancing T1 and T2 lesions. Conversely, patients with lower levels had a higher probability of achieving no evidence of disease activity status. An inverse relationship was noted between sNfL levels and cognitive function, measured by the Symbol Digit Modalities Test and Timed 25-Foot Walk scores.  

Investigators concluded that the sNfL served as a sensitive biomarker for monitoring multiple sclerosis progression and could offer a practical tool for disease and treatment management in clinical practice. 

Source: link.springer.com/article/10.1007/s00415-025-13093-1