title: Cerebrospinal fluid neurofilament tracks fMRI correlates of attention at the first attack of multiple sclerosis.
abstract: BACKGROUND
  Identifying markers of cognitive dysfunction in multiple sclerosis (MS) is extremely challenging since it means supplying potential biomarkers for neuroprotective therapeutic strategies.
  
  
  OBJECTIVE
  The aim of this study is to investigate the relationship between fMRI correlates of attention performance and cerebrospinal fluid (CSF) neurofilament light chain (NFL) levels in patients with clinically isolated syndrome (CIS) suggestive of MS.
  
  
  METHODS
  Twenty-one untreated, cognitively preserved CIS patients underwent BOLD-fMRI while performing the Variable Attentional Control (VAC) task, a cognitive paradigm requiring increasing levels of attentional control processing. CSF NFL was assessed by ELISA technique. SPM8 random-effects models were used for statistical analyses of fMRI data (p<0.05 corrected).
  
  
  RESULTS
  Repeated-measures ANOVA on imaging data showed an interaction between attentional control load and NFL levels in the right putamen. At the high level of attentional control demand CIS patients with "low NFL levels" showed greater activity in the putamen compared with subjects with "high NFL levels" (p=0.001). These results are independent of cognitive impairment index.
  
  
  CONCLUSIONS
  Our findings suggest a relationship between CSF NFL levels and load-dependent failure of putaminal recruitment pattern during sustained attention in CIS and suggest a role of CSF NFL as a marker of subclinical abnormality of cognitive pathway recruitment in CIS.
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy carla.tortorella@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Tortorella
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Direnzo
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Taurisano
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Romano
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ruggieri
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Zoccolella
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mastrapasqua
authors.affiliation: Unit of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico-Ospedale Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Foggia Italy.
authors.forename: T
authors.initials: T
authors.lastname: Popolizio
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Blasi
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bertolino
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Trojano
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology*; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003711:Demyelinating Diseases / Q000134:cerebrospinal fluid* / Q000150:complications / Q000503:physiopathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000150:complications / Q000503:physiopathology; D016900:Neurofilament Proteins / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D016900:Neurofilament Proteins; C044882:neurofilament protein L
keywords: Multiple sclerosis; attention; fMRI; neurofilament