Valerio Nicolella, Federica Novarella, Fabrizia Falco, Carmela Polito, Rosa Sirica, Evelina La Civita, Vincenzo Criscuolo, Giuseppe Corsini, Antonio Luca Spiezia, Alessia Castiello, Antonio Carotenuto, Maria Petracca, Roberta Lanzillo, Giuseppe Castaldo, Vincenzo Brescia Morra, Daniela Terracciano, Marcello Moccia
{"title":"血浆神经丝轻链与多发性硬化症患者的认知功能有关,但与患者报告的预后无关。","authors":"Valerio Nicolella, Federica Novarella, Fabrizia Falco, Carmela Polito, Rosa Sirica, Evelina La Civita, Vincenzo Criscuolo, Giuseppe Corsini, Antonio Luca Spiezia, Alessia Castiello, Antonio Carotenuto, Maria Petracca, Roberta Lanzillo, Giuseppe Castaldo, Vincenzo Brescia Morra, Daniela Terracciano, Marcello Moccia","doi":"10.3390/neurolint17090144","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We aimed to explore associations between plasma neurofilament light chain (pNfL) and cognition through patient-reported outcomes (PROs) in multiple sclerosis (MS).</p><p><strong>Methods: </strong>In this cross-sectional study, we included 211 people with MS (PwMS) and collected data from pNfL (fully automated chemiluminescent enzyme immunoassay), EDSS, education, cognition (the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT II), and Brief Visuospatial Memory Test-Revised (BVMT-R)), the Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI).</p><p><strong>Results: </strong>On multivariate linear regression models, higher educational attainment was significantly associated with lower pNfL (high school: Coeff = -0.22, 95% CI = -0.41 to -0.04, <i>p</i> = 0.019; university: Coeff = -0.22, 95% CI = -0.42 to -0.02, <i>p</i> = 0.030). In logistic regression models, the likelihood of having pNfL levels above normal thresholds increased by 56% for each one-point increment in the EDSS score (OR = 1.56, 95% CI = 1.23 to 1.98, <i>p</i> < 0.001) and was 2.5 times greater in individuals with impaired SDMT (OR = 2.50, 95% CI = 2.20 to 5.21, <i>p</i> = 0.014). No statistically significant associations were observed between pNfL and CVLT-II, BVMT-R, BDI-II, MFIS, BAI, or PSQI.</p><p><strong>Conclusions: </strong>Neuro-axonal damage in people with MS manifests clinically as increased disability and reduced attention and processing speed. However, these effects may be mitigated by greater brain resilience, as suggested by the protective role of higher educational attainment. The PROs assessed in this study showed no significant associations with pNfL levels, possibly due to measurement errors and heterogeneity, with limited sensitivity to neuro-axonal damage.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472482/pdf/","citationCount":"0","resultStr":"{\"title\":\"Plasma Neurofilament Light Chain Is Associated with Cognitive Functions but Not Patient-Reported Outcomes in Multiple Sclerosis.\",\"authors\":\"Valerio Nicolella, Federica Novarella, Fabrizia Falco, Carmela Polito, Rosa Sirica, Evelina La Civita, Vincenzo Criscuolo, Giuseppe Corsini, Antonio Luca Spiezia, Alessia Castiello, Antonio Carotenuto, Maria Petracca, Roberta Lanzillo, Giuseppe Castaldo, Vincenzo Brescia Morra, Daniela Terracciano, Marcello Moccia\",\"doi\":\"10.3390/neurolint17090144\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>We aimed to explore associations between plasma neurofilament light chain (pNfL) and cognition through patient-reported outcomes (PROs) in multiple sclerosis (MS).</p><p><strong>Methods: </strong>In this cross-sectional study, we included 211 people with MS (PwMS) and collected data from pNfL (fully automated chemiluminescent enzyme immunoassay), EDSS, education, cognition (the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT II), and Brief Visuospatial Memory Test-Revised (BVMT-R)), the Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI).</p><p><strong>Results: </strong>On multivariate linear regression models, higher educational attainment was significantly associated with lower pNfL (high school: Coeff = -0.22, 95% CI = -0.41 to -0.04, <i>p</i> = 0.019; university: Coeff = -0.22, 95% CI = -0.42 to -0.02, <i>p</i> = 0.030). In logistic regression models, the likelihood of having pNfL levels above normal thresholds increased by 56% for each one-point increment in the EDSS score (OR = 1.56, 95% CI = 1.23 to 1.98, <i>p</i> < 0.001) and was 2.5 times greater in individuals with impaired SDMT (OR = 2.50, 95% CI = 2.20 to 5.21, <i>p</i> = 0.014). No statistically significant associations were observed between pNfL and CVLT-II, BVMT-R, BDI-II, MFIS, BAI, or PSQI.</p><p><strong>Conclusions: </strong>Neuro-axonal damage in people with MS manifests clinically as increased disability and reduced attention and processing speed. However, these effects may be mitigated by greater brain resilience, as suggested by the protective role of higher educational attainment. The PROs assessed in this study showed no significant associations with pNfL levels, possibly due to measurement errors and heterogeneity, with limited sensitivity to neuro-axonal damage.</p>\",\"PeriodicalId\":19130,\"journal\":{\"name\":\"Neurology International\",\"volume\":\"17 9\",\"pages\":\"\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472482/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurology International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3390/neurolint17090144\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/neurolint17090144","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:通过多发性硬化症(MS)患者报告的预后(pro),探讨血浆神经丝轻链(pNfL)与认知之间的关系。方法:在本横断面研究中,我们纳入了211名多发性硬化症患者,收集了pNfL(全自动化学荧光酶免疫测定)、EDSS、教育、认知(符号数字模式测试(SDMT)、加州语言学习测试II (CVLT II)和简短视觉空间记忆测试修订(BVMT-R))、修正疲劳影响量表(MFIS)、贝克抑郁量表(BDI-II)、贝克焦虑量表(BAI)和匹兹堡睡眠质量指数(PSQI)的数据。结果:在多元线性回归模型中,较高的教育程度与较低的pNfL显著相关(高中:Coeff = -0.22, 95% CI = -0.41至-0.04,p = 0.019;大学:Coeff = -0.22, 95% CI = -0.42至-0.02,p = 0.030)。在logistic回归模型中,EDSS评分每增加1分,pNfL水平高于正常阈值的可能性增加56% (OR = 1.56, 95% CI = 1.23至1.98,p < 0.001), SDMT受损个体的pNfL水平高于正常阈值的可能性增加2.5倍(OR = 2.50, 95% CI = 2.20至5.21,p = 0.014)。pNfL与CVLT-II、BVMT-R、BDI-II、MFIS、BAI或PSQI之间无统计学意义的关联。结论:多发性硬化症患者的神经轴突损伤在临床上表现为残疾增加、注意力和处理速度降低。然而,这些影响可能会被更强的大脑弹性所缓解,正如高等教育程度所表明的那样。本研究评估的PROs与pNfL水平无显著相关性,可能是由于测量误差和异质性,对神经轴突损伤的敏感性有限。
Plasma Neurofilament Light Chain Is Associated with Cognitive Functions but Not Patient-Reported Outcomes in Multiple Sclerosis.
Objective: We aimed to explore associations between plasma neurofilament light chain (pNfL) and cognition through patient-reported outcomes (PROs) in multiple sclerosis (MS).
Methods: In this cross-sectional study, we included 211 people with MS (PwMS) and collected data from pNfL (fully automated chemiluminescent enzyme immunoassay), EDSS, education, cognition (the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT II), and Brief Visuospatial Memory Test-Revised (BVMT-R)), the Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI).
Results: On multivariate linear regression models, higher educational attainment was significantly associated with lower pNfL (high school: Coeff = -0.22, 95% CI = -0.41 to -0.04, p = 0.019; university: Coeff = -0.22, 95% CI = -0.42 to -0.02, p = 0.030). In logistic regression models, the likelihood of having pNfL levels above normal thresholds increased by 56% for each one-point increment in the EDSS score (OR = 1.56, 95% CI = 1.23 to 1.98, p < 0.001) and was 2.5 times greater in individuals with impaired SDMT (OR = 2.50, 95% CI = 2.20 to 5.21, p = 0.014). No statistically significant associations were observed between pNfL and CVLT-II, BVMT-R, BDI-II, MFIS, BAI, or PSQI.
Conclusions: Neuro-axonal damage in people with MS manifests clinically as increased disability and reduced attention and processing speed. However, these effects may be mitigated by greater brain resilience, as suggested by the protective role of higher educational attainment. The PROs assessed in this study showed no significant associations with pNfL levels, possibly due to measurement errors and heterogeneity, with limited sensitivity to neuro-axonal damage.