New diagnostic criteria in MS: The evolving role of biomarkers in Multiple Sclerosis

This expert panel discussion explores the current challenges in understanding and managing neuromyelitis optica spectrum disorder (NMOSD). Bringing together clinical perspectives, the conversation highlights gaps in pathophysiology, limitations in monitoring tools, and ongoing uncertainties in long-term treatment strategies. Despite advances in biomarkers and therapies, real-world decision-making remains largely driven by clinical experience.

Key Insights from the Lecture:

• Neurofilaments and GFAP are not specific to Multiple Sclerosis and should not replace established diagnostic assessment.
• Cerebrospinal fluid analysis, including oligoclonal bands and the kappa free light chain index, remains an important part of diagnostic evaluation.
• Serum neurofilaments may provide useful information when monitoring disease activity and treatment response.
• Evidence remains limited for using neurofilament levels alone to guide treatment decisions in individual patients.
• Low neurofilament levels do not necessarily exclude new lesions or ongoing disease activity.
• Biomarkers should complement clinical judgement and other clinical and paraclinical findings.
• Kappa free light chains may provide additional diagnostic information in cases where oligoclonal band results are negative or uncertain.
• Discordant results between oligoclonal bands and the kappa free light chain index can occur.
• Current evidence does not yet support replacing oligoclonal band testing entirely with kappa free light chains.
• Further validation across centres and populations is needed before changing established diagnostic practice.

“New diagnostic criteria in MS: The evolving role of biomarkers in Multiple Sclerosis”

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About the speaker:

Mario Habek

Dr. Habek is a Professor of Neurology at the University of Zagreb, School of Medicine, and a neuroimmunologist at the University Hospital Center Zagreb, where he serves as the Head of the Referral Center for Demyelinating Diseases of the CNS. His research focuses on abnormalities of the autonomic nervous system in demyelinating diseases of the CNS.

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