Examining changes in neurofilament light chain following a behavioral weight loss intervention for adults with multiple sclerosis and obesity

Abstract

Background: Obesity is associated with higher relapse rates and faster disease progression in Multiple Sclerosis (MS). It is unknown if weight loss is associated with reduced MS disease activity. The present study examines the effect of a behavioral weight loss intervention on MS disease activity, as measured by neurofilament light chain (NfL).

Methods: Participants were randomized to either the weight loss or control group. The weight loss group completed a 6-month telehealth group-based weight loss program, and a 6-month maintenance phase. Control group participants crossed over to receive the treatment after 6-months and then the maintenance phase. NfL samples were collected at each clinical visit. Treatment and control arms from the randomized trial were collapsed to perform cross-sectional analyses in the pre-intervention sample (n = 65). Spearman Rho correlations were used to examine associations between adjusted (age/BMI) and unadjusted pre-intervention NfL levels, and patient anthropometric, demographic, clinical, and treatment specific variables (i.e., diet, physical activity). A Mann-Whitney U Test was used to examine differences in NfL change between groups (intervention vs. control) at 6-months. Longitudinal associations between NfL change and percent weight loss, diet, and physical activity were also assessed with correlation analyses among the collapsed sample.

Results: Participant age was the only variable associated with NfL at baseline. Change in age and BMI adjusted NfL did not significantly differ between the intervention and control groups at 6-months (U = 201, p = .25). Despite clinically significant weight loss, there were no statistically significant differences between pre-/post-treatment levels or pre-/post-maintenance levels of NfL. Changes in diet and physical activity were not associated with changes in NfL. Additionally, NfL change was similar in participants who achieved or did not achieve clinically meaningful weight loss (5% or 10%).

Discussion: Overall, NfL remained stable over the course of the Modifying Diet and Exercise in MS (MoDEMS) intervention despite highly significant changes in weight loss and other anthropometrics. Findings indicate weight loss is not associated with decreased NfL in adults with relatively mild MS and obesity.