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AAN 2022 | The relationship between cerebral arterial blood flow and serum NfL in multiple sclerosis

Dejan Jakimovski, MD, PhD, Buffalo Neuroimaging Analysis Center, Buffalo, NY, explains his work on determining the effect of cardiovascular comorbidities on the health of patients with multiple sclerosis (MS). Both hypertension and lack of blood flow to the brain can lead to worse clinical outcomes. To better quantify these worse associations, Dr Jakimovski and his team used a specific biomarker of axonal pathology, being serum neurofilament light (NfL). They also measured the blood flow from the four main arteries going into the brain, defined as the cerebral arterial blood flow. It became evident that patients with lower cerebral arterial blood flow had higher levels of serum NfL in their blood stream, suggesting more extensive neurodegeneration. Nonetheless, a major limitation of this study was its cross-sectional nature, relying on data from a single time point. Therefore, it is not possible to determine causation (e.g., lower blood flow causing neurodegeneration, or a brain with neurodegeneration requiring less blood flow). Dr Jakimovski thinks that the next step is a longitudinal study to determine this and establish a time sequence for the development of pathology. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.