Application value of plasma Neurofilament light combined with magnetic resonance imaging to comprehensively evaluate multiple sclerosis activity and status.

Objective: Compare the levels of plasma neurofilament light (NfL) in patients with multiple sclerosis (MS) at acute and remission stages and healthy individuals to explore the role of plasma NfL in monitoring the activity and severity of the disease and predicting disease prognosis. Methods: Information on healthy individuals and patients with MS who visited the outpatient and inpatient departments of Inner Mongolia Medical University Affiliated Hospital from October 2020 to August 2022 was collected. EDSS assessment and plain scan+enhanced magnetic resonance imaging (MRI). Plasma Nfl levels were measured using Simoa. Moreover, the relationship between the level of Nlf and the disease status of patients with MS was analyzed.. Results: Through the self-comparison of the plasma NfL levels of MS patients in the acute and remission stages, it was noted that the levels in the acute stage are higher than those in the remission stage (p < 0.001). Among the plasma NfL levels of healthy individuals and MS patients in the acute and remission stages, there were statistically significant differences (p < 0.001). Furthermore, the plasma NfL level did not correlate with age or course of disease (p = 0.614 and p = 0.058), whereas it correlated with EDSS score, the number of MRI T2 subtentorial and spinal cord lesions, and the number of MRI enhanced lesions (r = 0.789, p < 0.001; r = 0.846, p < 0.001; r = 0431, p = 0.005, respectively). Conclusion: Combining the level of plasma NfL with clinical and MRI estimations will be instrumental in monitoring condition changes and optimizing treatments. The level of plasma NfL is related to the activity and severity of MS, and it is expected to become a new biomarker for assessing the activity and disease status of MS.

Treatment Efficacy and Risk Factors of Neurobrucellosis.

BACKGROUND: This study aimed to analyze the risk factors and treatment efficacy of neurobrucellosis. MATERIAL/METHODS: A cross-sectional epidemiologic survey was carried out in 557 patients with brucellosis by specially trained neurologic clinicians. Sixty-six patients with neurobrucellosis were treated with doxycycline, rifampicin, and ceftriaxone sodium as standard medication and evaluated for efficacy on a regular basis. RESULTS: (1) Symptoms improved in most patients after 6 weeks of treatment, which demonstrated a favorable efficacy. (2) Cross-sectional epidemiologic survey suggested that sex, nationality, and regional distribution were not related to nervous system damage in patients with brucellosis (P>0.05), whereas age and duration of disease were related factors. Increased age as well as a prolonged duration of disease were risk factors for nervous system damage in patients with brucellosis (P<0.05). CONCLUSIONS: (1) Doxycycline, rifampicin, and third-generation cephalosporins should be considered both standard and first-choice medications for neurobrucellosis. Treatment should last for at least 6 weeks. Standardized, sufficient, and combined medication is recommended for better efficacy and prognosis. (2) Age and duration of disease are risk factors for neurobrucellosis, whereas sex, nationality, and regional distribution are not. Older patients with a prolonged duration of disease are more likely to develop neurobrucellosis.