Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 15;272(6):400.
doi: 10.1007/s00415-025-13093-1.

The role of serum neurofilament light (sNfL) as a biomarker in multiple sclerosis: insights from a systematic review

Mark S Freedman  1 , Ahmed Abdelhak  2 , Mohit K Bhutani  3 , Jason Freeman  4 , Sharmilee Gnanapavan  5 , Salman Hussain  3 , Sheshank Madiraju  3 , Friedemann Paul  6   7
Affiliations

The role of serum neurofilament light (sNfL) as a biomarker in multiple sclerosis: insights from a systematic review

Mark S Freedman et al. J Neurol. .

Abstract

Objective: This systematic literature review (SLR) was conducted to explore the role of serum neurofilament light chain (sNfL) as a biomarker in multiple sclerosis (MS) disease management.

Methods: The review was conducted in accordance with the recommendation laid by the Cochrane Handbook for Systematic Reviews. A comprehensive literature search was performed in key biomedical databases (EMBASE®, MEDLINE®, MEDLINE®-In-Process, and all Evidence-Based Medicine [EBM] Reviews databases) to retrieve studies reporting the association between sNfL and disease activity in patients with MS. Additional evidence was also identified through hand searching of key conference proceedings and gray literature.

Results: Following review of 1831 records, 75 studies from 180 publications were included in the review. The studies included in the SLR consistently demonstrated an association between higher sNfL levels and an increased risk of future relapses within 2 years and MS disease progression. Higher levels of sNfL were also linked to an increased likelihood of experiencing gadolinium-enhancing T1 and T2 lesions. Patients with lower sNfL levels had a higher likelihood of achieving no evidence of disease activity status. Furthermore, an inverse correlation was observed between sNfL levels and cognitive impairment as assessed via the Symbol Digit Modalities Test performance and Timed 25-Foot Walk scores.

Conclusion: This SLR demonstrates the significance of sNfL as a sensitive biomarker for monitoring MS progression. Convenient and reliable sNfL measurement could benefit routine clinical practice, providing clinicians with a simple and effective tool to monitor disease and treatment response.

Keywords: Biomarker; Disease progression; Multiple sclerosis; Relapse; Serum neurofilament light chain (sNfL); Systematic review.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflicts of interest: Mark S. Freedman, in the previous 2 years, received research or educational grants from Sanofi-Genzyme Canada; received honoraria or consultation fees from Alexion/AstraZeneca, Biogen Idec, EMD Inc./EMD Serono/Merck Serono, Find Therapeutics, Hoffman La-Roche, Horizon Therapeutics/Amgen, Novartis, Sandoz, Sanofi-Genzyme, Sentrex, and Teva Canada Innovation; was a member of a company advisory board, board of directors, or other similar groups for Alexion/AstraZeneca, Actelion/Janssen (J&J), Atara Biotherapeutics, Bayer Healthcare, Celestra Health, EMD Inc./Merck Serono, Find Therapeutics, Hoffman La-Roche, Neurogenesis, Novartis, Sanofi-Genzyme, and Sentrex, Setpoint Medical; and participated in a speaker’s bureau sponsored by Hoffman La-Roche, Novartis, and EMD Inc. Ahmed Abdelhak received research funding from the German Multiple Sclerosis Society, the Department of Defense, and the UCSF Weill Institute for Neurosciences. He received speaker fees from Roche and consultation fee from Octave Bio. Jason Freeman is an employee of Novartis Pharmaceuticals, USA. Sharmilee Gnanapavan had received consultation fees and grant support from Novartis, Sanofi-Genzyme, Merck and Roche, UK MS Society, NMSS, NIHR, and NHS Digital. Friedemann Paul has no conflict of interest. Sheshank Madiraju, Salman Hussain, and Mohit K. Bhutani are employees of Novartis Healthcare Private Limited, India. Institutional review board statement: Not applicable. Informed consent: Not applicable. Consent to participate: Not applicable. Consent to publish: Not applicable.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram [27]
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Dobson R, Giovannoni G (2019) Multiple sclerosis—a review. Eur J Neurol 26:27–40. 10.1111/ene.13819 - PubMed
    1. Compston A, Coles A (2008) Multiple sclerosis. Lancet 372:1502–1517. 10.1016/s0140-6736(08)61620-7 - PubMed
    1. MS International Federation (2022) Atlas of MS 2022. https://www.atlasofms.org/map/united-kingdom/epidemiology/number-of-peop.... Accessed 17 October 2024.
    1. National Multiple Sclerosis Society (2019) New study doubles the previous estimate in the U.S. https://www.nationalmssociety.org/news-and-magazine/momentum-magazine/re.... Accessed 29 June 2024.
    1. GBD 2021 Nervous System Disorders Collaborators (2024) Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 23:344–381. 10.1016/s1474-4422(24)00038-3 - PMC - PubMed

Publication types

LinkOut - more resources