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EAN 2025 | The association between neurofilament and invisible symptoms of multiple sclerosis

Marcello Moccia, MD, PhD, from the University of Naples Federico II, Naples, Italy, comments on the association between neurofilament and invisible symptoms of multiple sclerosis, including cognitive dysfunction, depression, and fatigue. Dr Moccia notes that neurofilament levels are strongly correlated with cognitive dysfunction, whereas fatigue and depression do not appear to be directly related to neuroaxonal loss. This interview took place at the 11th Congress of the European Academy of Neurology (EAN 2025) in Helsinki, Finland.

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Transcript

In this abstract, we actually evaluated the correlates of neurofilament in relation to the invisible aspects of MS. Neurofilament is conventionally associated with motor symptoms of MS, such as disability progression, relapses or MRI activity in terms of new lesions. In this study, we evaluated the association with cognitive dysfunction and other invisible symptoms, including depression or fatigue...

In this abstract, we actually evaluated the correlates of neurofilament in relation to the invisible aspects of MS. Neurofilament is conventionally associated with motor symptoms of MS, such as disability progression, relapses or MRI activity in terms of new lesions. In this study, we evaluated the association with cognitive dysfunction and other invisible symptoms, including depression or fatigue. And it is very interesting that cognitive dysfunction has strong correlates with the neurofilament, especially when evaluated using the Symbol Digit Modality Test that is the reference for cognitive assessment in MS. By contrast, we did not find an association for fatigue and depression, suggesting that they are not necessarily related to neuroaxonal loss, but that there might be other mechanisms, chronic inflammation or chronic disconnection syndrome within the brain, that are definitely more difficult to study. And this also highlights the need of pathologically validated scales for invisible symptoms of MS.

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