| Abstract [eng] |
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system that most often manifests at a young age. MS commonly presents with a range of symptoms causing physical disability, assessed using the Expanded Disability Status Scale (EDSS). However, the EDSS reflects only the overall level of disability, largely dependent on walking distance, while objective and easily reproducible quantitative tests of motor status are not routinely used. Cognitive functions (CF) may be impaired in up to 75% of patients, yet the EDSS assesses them only superficially and does not differentiate between different cognitive domains. Specialized cognitive assessment is often limited in clinical practice by a lack of time and expertise. Structural neuronal protein subunits called neurofilament light chains (NFL) are released into the cerebrospinal fluid and blood during axonal degeneration. NFL is considered a potential future biomarker of MS progression and treatment efficacy. This dissertation examines the associations between CF impairment in people with MS and NFL concentration in cerebrospinal fluid and serum, as well as motor disability tests. A total of 99 people with MS and 37 controls were studied, with CF, motor function, and NFL concentration assessed twice at a 12-month interval. Factors associated with baseline CF impairment and its deterioration over time were identified. Practical recommendations for more detailed assessment of CF and motor function are proposed, and the practical value of serum NFL measurement in people with MS is discussed. |
