Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 12, Issue 2, Pages 143-148Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1191/135248506ms1263oa
Keywords
axonal damage; cerebrospinal fluid; clinically isolated syndrome; multiple sclerosis; neurofilaments; tau protein
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Clinically isolated syndrome (CIS) represents the earliest phase of multiple sclerosis ( MS). This study tested whether biomarkers for axonal degeneration can improve upon sensitivity and specificity of magnetic resonance imaging (MRI) parameters in predicting conversion from CIS to MS. Patients with CIS ( n = 52), relapsing-remitting MS ( RRMS, n = 38) and age-matched controls ( n = 25) were included. Cerebrospinal fluid (CSF) levels of tau and neurofilaments (NfH(SMI35)) were measured using ELISA. The MRI T2-lesion load and the Expanded Disability Status Scale (EDSS) were recorded. CSF tau and NfH(SMI35) were elevated in CIS compared to controls (P< 0.05). RRMS patients with acute relapse had higher NfH(SMI35) levels than stable patients. Tau and NfH(SMI35) levels correlated with EDSS in CIS and RRMS. In RRMS, the number of T2-lesions correlated with tau levels ( R = 0.53, P = 0.01). The sensitivity predicting the conversion from CIS to MS was higher for the combination of CSF markers ( either tau or NfH(SMI35) elevated) than for MRI ( 40 versus 34%), but could be further increased to 60% if CSF and MRI criteria were combined. Similarly, the combination of tau and NfH(SMI35) showed higher specificity (94%) than MRI (82%). Tau and NfHSMI35 are valuable biomarkers for axonal damage in the CIS patients. Predicting conversion from CIS to MS can be improved if CSF markers are combined with MRI.
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