This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Neurofilaments (Nf), structural proteins of axons and dendrites, are composed of light (NfL), medium (NfM), and heavy (NfH) chain subunits. Due to their abundance and specificity for neurons, they have potential as markers of neuronal injury. Neuroaxonal damage releases Nf proteins into the extracellular space, CSF, and peripheral blood. Studies in diseases characterized by neuroaxonal loss (stroke, amyotrophic lateral sclerosis, Alzheimer disease, HIV-associated cognitive impairment, acute spinal cord injury, neuromyelitis optica, and multiple sclerosis [MS]) reported the utility of Nf as a potential surrogate marker.
Nf studies in MS showed that levels correlated with disease activity. In 78% of patients with relapsing-remitting MS (RRMS) (but in no controls), there was detectable CSF NfL; levels rose after relapse and decreased over 3 months.1 A cross-sectional study reported detectable CSF NfL in 8% of controls, 48% of subjects with secondary progressive MS (SPMS), 44% with RRMS in remission, and 91% with RRMS who had relapsed in the preceding 3 months. Thirteen recent-relapse subjects studied longitudinally showed median NfL levels at baseline of 1.88 ng/mL, increasing to 2.70 ng/mL at 5 weeks and significantly raised at 2.02 ng/mL 15 weeks after relapse.2 A recent long-term study confirmed the utility of CSF NfL: baseline CSF NfL correlated with MS severity score (MSSS) with a median follow-up of 14 years.3 CSF NfL above the median conferred a higher risk for severe MS compared to subjects with a more benign course (odds …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
