Serum NSE level and disability progression in multiple sclerosis

Abstract

Background: Previous studies suggested that serum neuron specific enolase (NSE) may be a biomarker associated with progression in MS. Methods: We measured serum NSE levels in 385 patients with multiple sclerosis (MS) (264 with relapsing–remitting (RR) MS, 86 with secondary progressive (SP) MS, and 35 with primary progressive (PP) MS), and compared levels between disease courses, between users and non-users of immunomodulatory treatment, and between patients with worsening or stable disability at one year follow-up (available in 161 patients). We also investigated the correlation between serum NSE and Expanded Disability Status Scale (EDSS) and MS Severity Score (MSSS) scores in the whole cohort and in subgroups, and built a multiple linear regression model to assess the influence of predictor variables on serum NSE. Results: Age was the only independent predictor of serum NSE levels in the multiple linear regression model. In the subgroup of patients with PPMS, there was a moderate correlation between serum NSE and increasing MSSS (Pearson's r 0.35, p=0.04) and EDSS (Spearman's rho 0.37, p=0.03) scores. Conclusion: Our data do not support the use of serum NSE as a prognostic biomarker in RRMS or SPMS. The correlations of serum NSE with EDSS and MSSS in the PPMS subgroup are interesting, but based on a small sample size and require replication in other cohorts.