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Association Between Fatigue, Information Processing Speed and Plasma Levels of Glial Fibrillary Acidic Protein and Neurofilament Light in Patients With Relapsing–Remitting Multiple Sclerosis Treated With Natalizumab or Rituximab

Hellgren, Johan LU ; Compagno Strandberg, Maria LU ; Hansson, Oskar LU orcid ; Janelidze, Shorena LU ; Källén, Kristina LU and Svenningsson, Anders (2026) In Acta Neurologica Scandinavica 2026(1).
Abstract

Background: Patients with relapsing–remitting multiple sclerosis (RRMS) experience fatigue and impaired information processing speed (IPS) frequently, even in the absence of clinical or radiological disease activity. Previous studies investigating associations between fatigue, IPS, neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have reported conflicting results. Objective: To examine potential associations between GFAP and NfL with fatigue and IPS in patients with RRMS treated with rituximab (RTX) or natalizumab (NTZ). Methods: In this Swedish multicentre cross-sectional study, we measured plasma GFAP and NfL levels using Simoa Neurology 2-PLEX B Kit in 121 clinically stable patients with RRMS treated with... (More)

Background: Patients with relapsing–remitting multiple sclerosis (RRMS) experience fatigue and impaired information processing speed (IPS) frequently, even in the absence of clinical or radiological disease activity. Previous studies investigating associations between fatigue, IPS, neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have reported conflicting results. Objective: To examine potential associations between GFAP and NfL with fatigue and IPS in patients with RRMS treated with rituximab (RTX) or natalizumab (NTZ). Methods: In this Swedish multicentre cross-sectional study, we measured plasma GFAP and NfL levels using Simoa Neurology 2-PLEX B Kit in 121 clinically stable patients with RRMS treated with either RTX or NTZ for at least 24 months. Fatigue and IPS were assessed using the Fatigue Scale for Motor and Cognitive Functions (FSMC) and the Symbol Digit Modalities Test (SDMT), respectively. Results: No significant associations were found between GFAP or NfL levels and FSMC or SDMT scores. No significant differences in GFAP or NfL levels were observed between RTX- and NTZ-treated groups. Conclusion: No associations were found between fatigue, IPS, GFAP and NfL. GFAP and NfL levels in stable RRMS patients treated with off-label RTX were low and did not significantly differ from those treated with NTZ, possibly suggesting a low risk of long-term disability progression for patients treated with either therapy.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
fatigue, glial fibrillary acidic protein, information processing speed, natalizumab, neurofilament light, rituximab
in
Acta Neurologica Scandinavica
volume
2026
issue
1
article number
5453262
publisher
Wiley-Blackwell
external identifiers
  • scopus:105037934757
ISSN
0001-6314
DOI
10.1155/ane/5453262
language
English
LU publication?
yes
additional info
Publisher Copyright: Copyright © 2026 Johan Hellgren et al. Acta Neurologica Scandinavica published by John Wiley & Sons Ltd.
id
fc90f474-eb67-41c6-a6e7-2698a3cbaa9b
date added to LUP
2026-07-15 09:32:07
date last changed
2026-07-15 09:35:44
@article{fc90f474-eb67-41c6-a6e7-2698a3cbaa9b,
  abstract     = {{<p>Background: Patients with relapsing–remitting multiple sclerosis (RRMS) experience fatigue and impaired information processing speed (IPS) frequently, even in the absence of clinical or radiological disease activity. Previous studies investigating associations between fatigue, IPS, neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have reported conflicting results. Objective: To examine potential associations between GFAP and NfL with fatigue and IPS in patients with RRMS treated with rituximab (RTX) or natalizumab (NTZ). Methods: In this Swedish multicentre cross-sectional study, we measured plasma GFAP and NfL levels using Simoa Neurology 2-PLEX B Kit in 121 clinically stable patients with RRMS treated with either RTX or NTZ for at least 24 months. Fatigue and IPS were assessed using the Fatigue Scale for Motor and Cognitive Functions (FSMC) and the Symbol Digit Modalities Test (SDMT), respectively. Results: No significant associations were found between GFAP or NfL levels and FSMC or SDMT scores. No significant differences in GFAP or NfL levels were observed between RTX- and NTZ-treated groups. Conclusion: No associations were found between fatigue, IPS, GFAP and NfL. GFAP and NfL levels in stable RRMS patients treated with off-label RTX were low and did not significantly differ from those treated with NTZ, possibly suggesting a low risk of long-term disability progression for patients treated with either therapy.</p>}},
  author       = {{Hellgren, Johan and Compagno Strandberg, Maria and Hansson, Oskar and Janelidze, Shorena and Källén, Kristina and Svenningsson, Anders}},
  issn         = {{0001-6314}},
  keywords     = {{fatigue; glial fibrillary acidic protein; information processing speed; natalizumab; neurofilament light; rituximab}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Neurologica Scandinavica}},
  title        = {{Association Between Fatigue, Information Processing Speed and Plasma Levels of Glial Fibrillary Acidic Protein and Neurofilament Light in Patients With Relapsing–Remitting Multiple Sclerosis Treated With Natalizumab or Rituximab}},
  url          = {{http://dx.doi.org/10.1155/ane/5453262}},
  doi          = {{10.1155/ane/5453262}},
  volume       = {{2026}},
  year         = {{2026}},
}