THURSDAY, Nov. 16, 2023 (HealthDay News) — Pronounced neuroaxonal damage precedes disability worsening events with or without preceding clinical relapses in people with multiple sclerosis (MS), according to a study published online Nov. 6 in JAMA Neurology.

Ahmed Abdelhak, M.D., from University of California at San Francisco, and colleagues assessed whether and when neurofilament light chain (NfL) levels are elevated in the context of confirmed disability worsening (CDW) with MS. The analysis included data from two observational cohorts seen at tertiary MS centers (609 and 1,290 participants).

The researchers found that NfL z scores were 0.71 units higher in the first cohort and 0.32 higher in the second cohort for CDW associated with clinical relapse versus stable MS. Higher NfL was detected preceding CDW independent of clinical relapse for two visits preceding the event and for the visit directly preceding the event. Findings were similar for the subset of individuals with relapsing-remitting MS.

“This cohort study documents the occurrence of NfL elevation in advance of clinical worsening and may hint to a potential window of ongoing dynamic central nervous system pathology that precedes the diagnosis of CDW,” the authors write.

Several authors disclosed ties to industry.

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