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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Fredrik Piehl, Karolinska Institutet, Sweden
- Second opponent: Senior Consultant Anette Margrethe Storstein, Haukeland University Hospital, Norway
- Third member and chair of the evaluation committee: Professor II Morten Carstens Moe, University of Oslo, Norway
Chair of the Defence
Professor II Anne Flem Jacobsen, University of Oslo
Principal Supervisor
Professor II Hanne Flinstad Harbo, University of Oslo
Summary
The course of multiple sclerosis (MS) is unpredictable and predicting clinical outcomes remains challenging. Therefore, biomarkers that reflect disease severity or may predict disease course are highly needed.
Pathological processes in MS can be assessed and quantified by different paraclinical biomarkers, including brain and spinal cord MRI, retinal optical coherence tomography (OCT), and analysis of cerebrospinal fluid and peripheral blood.
The overall aim of this thesis was to investigate specific MRI methods, serum neurofilament light chain (sNfL) concentrations, OCT, and frequencies of immune cell subsets in blood as biomarkers of disease activity and disease worsening in MS, by investigating these specific biomarkers in two clinical cohorts of MS patients using relevant methods.
We found that the automated software LesionQuant (LQ) provides an automated tool for evaluating lesions and detecting early signs of atrophy.
We confirmed that the blood-based biomarker sNfL is a marker of disease activity as we found that sNfL was associated with clinical disability and MRI measures. MS patients who experienced disease worsening had higher levels of sNfL compared to stable patients, and patients with high sNfL concentrations at baseline had a 2.8-fold increased risk of disease worsening at two-year follow-up.
Furthermore, the risk of disease worsening was slightly increased in patients who had both high sNfL and high frequencies of specific immune cells in the blood, and particularly high frequencies of pro-inflammatory Th17 cells.
Overall, the results presented in this thesis support that LQ is a promising supplement to the visual inspection performed by neuroradiologists. Furthermore, the results demonstrates that sNfL might be a useful biomarker for disease worsening and relevant in a clinical setting. Finally, the results support the use of immune cells in blood as a potential biomarker in MS.
Additional information
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