2023 American Academy of Neurology Abstract Website

Juan Pablo Cuello¹, Ariana Meldaña Rivera³, Jose Manuel Garcia Dominguez⁴, Alexander Rodero Romero⁵, Haydee Goicochea Briceño¹, Elda María Alba Suarez¹, Enric Monreal Laguillo⁵, Susana Sainz de la Maza Cantero⁵, Lucienne Costa-Frossard⁵, juan de-León Luis², Carmen Martinez Asensio², Lourdes Fátima Yllana Pérez², Yolanda Higueras³, Maria Luisa Martinez Gines¹, Luisa Maria Villar Guimerans ⁵
¹Neurology, Hospital General Universitario Gregorio Maran, ²Hospital General Universitario Gregorio Maran, ³Instituto de Investigación Sanitaria del Gregorio Marañon (IISGM), ⁴Hospital General Universitario Gregorio Marañón, ⁵Immunology, Hospital Universitario Ramón y Cajal. Madrid

Objective:

To explore the utility of Neurofilament light chain (NfL) and Antimüllerian hormone (AMH) in family planning in multiple sclerosis (MS).

Background:

Serum NfL values are considered biomarkers for neuroaxonal injury. Their levels associate with relapse activity, disability scores, and treatment response in MS. On the other hand, AMH levels are a reliable marker of ovarian reserve and age at menopause. Interestingly, serum AMH levels do not change significantly throughout the menstrual cycle

Design/Methods:

A cross-sectional study was performed. We included naïve patients with MS, recruited at the time of diagnosis. Clinical and epidemiological data were analyzed. Serum NfL levels were measured with a sensitive single-molecule array (SIMOA) assay, and AMH levels were measured by ELISA. Descriptive and multivariate analyses were performed. Results are expressed by median and interquartile range 25%-75%.

Results:

We included 112 MS patients. Median age 35.25 years old (30.35-40.65). We divided the patients into two groups according to their AMH levels, using values that represented a median ovarian reserve. We found that age was significantly associated with AMH levels (P < 0.01. Median AMH values 0.2 ng/ml [0.1-0.5]). We further divided our participants into two groups according to their NfL levels using a cut-off value of 10 pg/ml and found no statistical difference between groups (p: 0.3; median NfL: 7.5 pg/mL [5.5- 12.2]). Interestingly, when analyzing individual patients, we were able to identify those with an unexpectedly low AMH level, regardless of their age.

Conclusions:

AMH levels can also be used as a biomarker of ovarian reserve in MS patients. Furthermore, our data suggest that AMH and NfL levels at diagnosis might help develop a personalized treatment strategy in patients of childbearing age and support informed decisions about whether or not to delay childbearing.