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Higher blood levels of a molecule called Neurofilament light chain (NfL) were associated with progression of disability in blood samples from 4,385 people with MS. Although further study is needed before this blood test can be used routinely to predict disease course and guide the care of individuals with MS, these findings add to growing evidence that NfL has potential as a predictive biomarker of MS disease activity and disability progression. .

• NfL is a fragment that is part of the debris that enters the spinal fluid and blood when nerve wires (axons) are damaged. Studies of NfL in the bloodstream and in spinal fluid have been underway to better define how this biomarker may be employed to help detect and predict disease activity and response to treatments, not only in MS but in other disorders.
• In this large study, the researchers identified 4,385 people with MS from Swedish MS registries, and 1,026 people who did not have MS. They tested NfL levels in blood samples and followed the participants for five years.
• People with MS had significantly higher levels of NfL in their blood, compared to people without MS. Higher NfL levels were significantly associated with worsening disability during the next year and with the likelihood of reaching moderate disability (affecting daily activities but not walking ability).
• This large study adds to a growing body of knowledge needed to determine the best use of NfL as a biomarker for MS care, treatment decisions, and clinical trials. Additional studies underway will help standardize its use and help understand how age and other health conditions impact NfL levels. 

Plasma neurofilament light levels are associated with the risk of disability in multiple sclerosis” by Ali Manouchehrinia, PhD, and colleagues from the Karolinska Institutet was published on May 20, 2020 in Neurology.