Low Cerebrospinal Fluid Amyloid Beta Levels Predict MS Disease Progression

For patients with multiple sclerosis, low cerebrospinal fluid (CSF) amyloid beta_1-42 (Aβ) levels may be a predictive biomarker for disease progression, according to results published in the Multiple Sclerosis Journal.

The study included participants with a new diagnosis of relapsing-remitting multiple sclerosis who were followed for 3 to 5 years (n=60). Participants underwent clinical assessment, brain magnetic resonance imaging (at baseline and 1 year), and CSF analysis to determine Aβ levels. Expanded Disability Status Scale (EDSS) scores were assessed at baseline and at each follow-up visit at 6-month intervals. The researchers calculated T1-weighted volumes and T2-weighted scans to quantify white matter lesion loads.

Participants who had worse follow-up EDSS scores (≥3) had lower CSF Aβ levels (650.8±204.8 pg/mL) compared with those with EDSS scores <3 (941.9±280.2 pg/mL; P <.0001). After performing a multiple regression analysis, the researchers confirmed that CSF Aβ concentration is a predictor of EDSS score increase (r=-0.59, P <.0001).

The researchers generated a receiver operating characteristic curve and determined that a cut-off value of 813 pg/mL could identify participants with worse prognosis (95% CI, 0.690-0.933, P =.0001).

“It remains to be clarified whether [Aβ] plays a causal role or represents the epiphenomenon of a neuroaxonal reparative process, or it plays a proper protective role,” the researchers wrote.

Reference

Pietroboni AM, Caprioli M, Carandini T, et al. CSF β-amyloid predicts prognosis in patients with multiple sclerosis [published online August 7, 2018]. Mult Scler. doi:10.1177/1352458518791709