Introduction: Multiple sclerosis (MS) is a chronic inflammatory, autoimmune, demyelinating disease of the central nervous system that is often associated with cognitive impairment. This study aims to investigate whether Neurofilament light chain (NfL) and B Lymphocyte Chemoattractant (CXCL13) are potential biomarkers for detecting cognitive impairment in MS.
Methods: 57 patients with Radiologically Isolated Syndrome (RIS), Clinically Isolated Syndrome (CIS) or Relapsing-remitting MS (RRMS) and 70 healthy controls were studied. NfL and CXCL13 were measured by ELISA (the Enzyme-Linked ImmunoSorbent Assay) in the patients’ cerebrospinal fluid (CSF) and serum samples. The Turkish-validated version of Brief International Cognitive Assessment for MS (BICAMS) test was applied. Serum biomarker levels and cognition tests were compared between the control and patient groups.
Results: Serum NfL and CXCL13 values were significantly higher in the patient group (p = 0.043 and p < 0.001, respectively) compared to healthy controls. BICAMS were lower in the patient group (p<0.001). CSF CXCL13 levels demonstrated a significant negative correlation (p = 0.034) with California Verbal Learning Test-2 (CVLT-II) subtest scores, while CSF NfL levels showed a trend towards a negative association (p=0.067) with this subtest. There were no significant relationships between the serum or CSF biomarkers and the BICAMS total scores.
Conclusion: NfL and CXCL13 potential biomarkers may not be associated with cognitive impairment in MS patients. The limitations of this study include the absence of CSF data from healthy individuals and the lack of stratification by clinical MS subtypes (RIS, CIS, or RRMS). Since they have been seen as promising biomarkers in MS, further studies are needed to determine this potential relationship.
Keywords: Biomarker, cognitive ımpairment, CXCL13, multiple sclerosis,