Clinical application of age-derived cut-offs for plasma neurofilament light chain in multiple sclerosis.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2025-07-09 DOI:10.1007/s00415-025-13223-9

Valerio Nicolella, Marco Varelli, Stefania Fasano, Rosa Sirica, Carmela Polito, Aniello Saviano, Mariano Fiorenza, Federica Novarella, Davide Ranucci, Antonio Carotenuto, Maria Petracca, Roberta Lanzillo, Vincenzo Brescia Morra, Giuseppe Castaldo, Daniela Terracciano, Marcello Moccia

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引用次数: 0

Abstract

Objective: Clinical use of neurofilament light chain (NfL) requires cut-off values that reflect disease status independently of confounding factors, such as age, hemodilution, and cardiovascular risk factors. We compared the performance of different previously suggested cut-offs in separating MS cases and controls, and in identifying different MS clinical features, across age groups.

Methods: In this cross-sectional study, we included people with MS (n = 312) and age-, sex-, and eGFR-matched controls (n = 236). For MS cases, we collected descriptor of disease progression (relapsing or progressive), EDSS, and evidence of disease activity in the previous year (including relapses, active MRI, and EDSS progression) and disease duration. Plasma NfL (pNfL) was evaluated using Lumipulse™ fully automated chemiluminescent enzyme immunoassay. We then classified both MS cases and controls based on pNfL suggested by Simrèn et al. (specific for different age ranges), Vermunt et al. (age-derived percentiles), and Benkert et al. (age- and BMI-derived percentiles).

Results: In individuals aged 18-50 years, the three suggested pNfL cut-offs provided high specificity (> 85%) in discriminating MS cases and controls (AUC = 0.73; 95%CI = 0.67, 0.78; p = 0.028). In the MS population, the three suggested pNfL cut-offs provided high sensitivity (> 75%) in discriminating relapsing and progressive cases (AUC = 0.70; 95%CI = 0.63, 0.77; p = 0.034), patients with EDSS ≥ 4.0 and EDSS < 4.0 (AUC = 0.69; 95%CI = 0.63, 0.76; p = 0.032), and patients with EDSS ≥ 6.0 and EDSS < 6.0 (AUC = 0.70; 95%CI = 0.62, 0.78; p = 0.040). The three suggested pNfL cut-offs provided lower accuracy in age groups older than 50 years.

Conclusions: Previously validated cut-offs provided similar sensitivity and specificity in separating MS cases and controls and in identifying MS clinical features across different age groups, with the best performance before 50 years.

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年龄源性血浆神经丝轻链切断在多发性硬化中的临床应用。

目的：神经丝轻链（NfL）的临床应用需要能够独立于年龄、血液稀释度、心血管危险因素等混杂因素反映疾病状态的截止值。我们比较了不同的先前建议的切断在区分MS病例和对照方面的表现，以及在确定不同年龄组MS临床特征方面的表现。方法：在这项横断面研究中，我们纳入了MS患者（n = 312）和年龄、性别和egfr匹配的对照组（n = 236）。对于MS病例，我们收集了疾病进展描述符（复发或进展），EDSS，以及前一年疾病活动的证据（包括复发，活跃MRI和EDSS进展）和疾病持续时间。使用Lumipulse™全自动化学发光酶免疫分析法评估血浆NfL （pNfL）。然后，我们根据simmr等人（针对不同年龄范围）、vermont等人（年龄衍生百分位数）和Benkert等人（年龄和bmi衍生百分位数）建议的pNfL对MS病例和对照组进行分类。结果：在18-50岁的个体中，三个建议的pNfL截断值在区分MS病例和对照组方面具有高特异性（约85%）(AUC = 0.73；95%ci = 0.67, 0.78；p = 0.028)。在MS人群中，三个建议的pNfL截断值在区分复发和进展病例方面提供了高灵敏度（约75%）(AUC = 0.70；95%ci = 0.63, 0.77；结论：先前验证的截断值在区分MS病例和对照以及识别不同年龄组MS临床特征方面具有相似的敏感性和特异性，其中50岁之前的效果最好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.