Neurofilament Light Chain as a Discriminator of Disease Activity Status in MOG Antibody-Associated Disease
Ana Beatriz Ayroza Galvão Ribeiro Gomes, Su‐Hyun Kim, Roxanne Pretzsch, Laila Kulsvehagen, Sabine Schädelin, J.T. Lerner, Nora Sandrine Wetzel, Pascal Benkert, Aleksandra Maleska Maceski, Jae‐Won Hyun, Anne-Catherine Lecourt, Patrick Lipps, Vinícius Andreoli Schoeps, Aline de Moura Brasil Matos, Natália Trombini Mendes, Samira Luísa Apóstolos‐Pereira, Matthias Mehling, Tobias Derfuß, Ludwig Kappos, Dagoberto Callegaro, Jens Kühle, Ho Jin Kim, Anne‐Katrin Pröbstel
Abstract
BACKGROUND AND OBJECTIVES: In patients with myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD), acute disease activity is generally identified through medical history, neurologic examination, and imaging. However, these may be insufficient for detecting disease activity in specific conditions. This study aimed to investigate the dynamics of serum neurofilament light chain (sNfL) and serum glial fibrillary acidic protein (sGFAP) after clinical attacks and to assess their utility in discriminating attacks from remission in patients with MOGAD. METHODS: We conducted a multicenter, retrospective, longitudinal study including 239 sera from 62 MOGAD patients assessed from 1995 to 2023 in a discovery and validation setup. Sera were measured for sNfL and sGFAP with a single-molecule array assay and for MOG-IgG with a live cell-based assay. sNfL and sGFAP Z scores and percentiles adjusted for age, body mass index, and sex (sGFAP) were calculated from a healthy control normative database. Mixed-effects regression models were used to characterize biomarkers' dynamics and to investigate associations between serum biomarkers, clinical variables, and disease activity status. RESULTS: < 0.001). Logistic models incorporating sNfL Z scores demonstrated favorable performance in discriminating disease activity status across both cohorts. DISCUSSION: sNfL Z scores may serve as a biomarker for monitoring disease activity in MOGAD.