{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:05:07Z","timestamp":1757613907389,"version":"3.44.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Dutch National MS Foundation","award":["OZ2018-007"],"award-info":[{"award-number":["OZ2018-007"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>In relapsing-remitting multiple sclerosis (RRMS), the assessment of clinical disease activity can be challenging.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>To determine the diagnostic potential of serum neurofilament light (sNfL) and glial fibrillary acidic protein (sGFAP) to distinguish a relapse from other causes of deterioration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this multicenter, prospective study, RRMS patients with new neurological symptoms in the last 14 days were followed for 12 weeks. A diagnosis was established by the treating physician or, when in doubt, a panel of experienced neurologists. Blood samples were taken at baseline and week 12.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>\n              A total of 65 patients were included. At baseline, patients with a clear relapse had a significantly higher median sNfL (14.6 pg\/mL) than those with a clear other cause (9.5 pg\/mL,\n              <jats:italic>p<\/jats:italic>\n              \u2009=\u20090.004). Although not significant after correction for multiple testing, median sGFAP was also higher in relapse patients (73.0 vs 64.6 pg\/mL,\n              <jats:italic>p<\/jats:italic>\n              \u2009=\u20090.036). An sNfL value below 6.0 pg\/mL had a high sensitivity (67% at baseline (CI 22.3\u201395.7%) and 100% at follow-up (CI 54.1\u2013100%)) to rule out a relapse.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Analysis of sNfL level can be useful as an add-on investigation to determine whether disease activity is present in patients with RRMS presenting with new symptoms.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1177\/20552173251370830","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T12:07:07Z","timestamp":1756814827000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Relapse or no relapse in multiple sclerosis: Can disease activity biomarkers support the clinician?"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-0195","authenticated-orcid":false,"given":"Jeske","family":"van Pamelen","sequence":"first","affiliation":[{"name":"Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands"},{"name":"MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3939-7394","authenticated-orcid":false,"given":"Marleen J A","family":"Koel-Simmelink","sequence":"additional","affiliation":[{"name":"Neurochemistry Laboratory, Department of Laboratory Medicine, Amsterdam Neuroscience, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9448-1826","authenticated-orcid":false,"given":"Birgit I","family":"Lissenberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5944-5931","authenticated-orcid":false,"given":"Edo P J","family":"Arnoldus","sequence":"additional","affiliation":[{"name":"Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6089-9896","authenticated-orcid":false,"given":"Janet","family":"de Beukelaar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Albert Schweitzer Hospital, Dordrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4043-4729","authenticated-orcid":false,"given":"Judith","family":"van Vliet","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6347-5957","authenticated-orcid":false,"given":"Joep","family":"Killestein","sequence":"additional","affiliation":[{"name":"MS Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4061-0837","authenticated-orcid":false,"given":"Charlotte E","family":"Teunissen","sequence":"additional","affiliation":[{"name":"Neurochemistry Laboratory, Department of Laboratory Medicine, Amsterdam Neuroscience, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0704-4538","authenticated-orcid":false,"given":"Leo H","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"},{"key":"e_1_3_3_3_2","first-page":"20161207","article-title":"Assessment and treatment strategies for a multiple sclerosis relapse","volume":"5","author":"Wang C","year":"2018","unstructured":"Wang C, Ruiz A, Mao-Draayer Y. 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