{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:58:02Z","timestamp":1772171882654,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MUR PNRR Extended Partnership","award":["PE00000006"],"award-info":[{"award-number":["PE00000006"]}]},{"name":"MUR PNRR Extended Partnership","award":["PNC-E3- 2022-23683267"],"award-info":[{"award-number":["PNC-E3- 2022-23683267"]}]},{"name":"MUR PNRR Extended Partnership","award":["CUP E65E24002260002"],"award-info":[{"award-number":["CUP E65E24002260002"]}]},{"name":"Campania Region NeuroDiaTE Project","award":["PE00000006"],"award-info":[{"award-number":["PE00000006"]}]},{"name":"Campania Region NeuroDiaTE Project","award":["PNC-E3- 2022-23683267"],"award-info":[{"award-number":["PNC-E3- 2022-23683267"]}]},{"name":"Campania Region NeuroDiaTE Project","award":["CUP E65E24002260002"],"award-info":[{"award-number":["CUP E65E24002260002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Objective: We aimed to explore associations between plasma neurofilament light chain (pNfL) and cognition through patient-reported outcomes (PROs) in multiple sclerosis (MS). Methods: In this cross-sectional study, we included 211 people with MS (PwMS) and collected data from pNfL (fully automated chemiluminescent enzyme immunoassay), EDSS, education, cognition (the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT II), and Brief Visuospatial Memory Test\u2013Revised (BVMT-R)), the Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI). Results: On multivariate linear regression models, higher educational attainment was significantly associated with lower pNfL (high school: Coeff = \u22120.22, 95% CI = \u22120.41 to \u22120.04, p = 0.019; university: Coeff = \u22120.22, 95% CI = \u22120.42 to \u22120.02, p = 0.030). In logistic regression models, the likelihood of having pNfL levels above normal thresholds increased by 56% for each one-point increment in the EDSS score (OR = 1.56, 95% CI = 1.23 to 1.98, p &lt; 0.001) and was 2.5 times greater in individuals with impaired SDMT (OR = 2.50, 95% CI = 2.20 to 5.21, p = 0.014). No statistically significant associations were observed between pNfL and CVLT-II, BVMT-R, BDI-II, MFIS, BAI, or PSQI. Conclusions: Neuro-axonal damage in people with MS manifests clinically as increased disability and reduced attention and processing speed. However, these effects may be mitigated by greater brain resilience, as suggested by the protective role of higher educational attainment. The PROs assessed in this study showed no significant associations with pNfL levels, possibly due to measurement errors and heterogeneity, with limited sensitivity to neuro-axonal damage.<\/jats:p>","DOI":"10.3390\/neurolint17090144","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T19:16:17Z","timestamp":1757445377000},"page":"144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Plasma Neurofilament Light Chain Is Associated with Cognitive Functions but Not Patient-Reported Outcomes in Multiple Sclerosis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0756-9877","authenticated-orcid":false,"given":"Valerio","family":"Nicolella","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Novarella","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4585-1867","authenticated-orcid":false,"given":"Fabrizia","family":"Falco","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"},{"name":"Multiple Sclerosis Unit, Policlinico Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmela","family":"Polito","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Sirica","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelina","family":"La Civita","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Criscuolo","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2377-6181","authenticated-orcid":false,"given":"Giuseppe","family":"Corsini","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3287-3247","authenticated-orcid":false,"given":"Antonio Luca","family":"Spiezia","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Castiello","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1574-9693","authenticated-orcid":false,"given":"Antonio","family":"Carotenuto","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"},{"name":"Multiple Sclerosis Unit, Policlinico Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Petracca","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-8180","authenticated-orcid":false,"given":"Roberta","family":"Lanzillo","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"},{"name":"Multiple Sclerosis Unit, Policlinico Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Castaldo","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, 80131 Naples, Italy"},{"name":"Centre for Advanced Biotechnology (CEINGE), 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Brescia Morra","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy"},{"name":"Multiple Sclerosis Unit, Policlinico Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4296-429X","authenticated-orcid":false,"given":"Daniela","family":"Terracciano","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2613-3090","authenticated-orcid":false,"given":"Marcello","family":"Moccia","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Unit, Policlinico Federico II University Hospital, 80131 Naples, Italy"},{"name":"Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/brain\/awn275","article-title":"Disconnection as a mechanism for cognitive dysfunction in multiple sclerosis","volume":"132","author":"Dineen","year":"2009","journal-title":"Brain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/S1474-4422(20)30277-5","article-title":"Cognitive 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