Impact of Dietary Intervention on Serum Neurofilament Light Chain in Multiple Sclerosis.
Level 2 - randomized trial
Retrospective biomarker analysis of a prospective randomized controlled trial
PubMed 34764215 · doi:10.1212/NXI.0000000000001102
What was done
Researchers evaluated serum neurofilament light chain (sNfL) levels in a retrospective biomarker analysis of a prospective randomized controlled trial (originally 60 patients with relapsing-remitting multiple sclerosis). sNfL was measured via single molecule array assay at baseline and 6 months in 40 participants across three arms: common diet control (n = 9), caloric restriction/fasting (n = 14), and adapted ketogenic diet (AKD, n = 17).
What was found
sNfL correlated with age, disease duration, and Multiple Sclerosis Functional Composite scores. The AKD group showed a significant reduction in sNfL levels at 6 months compared with the common diet control group (p = 0.001). A single 7-day fasting cycle did not affect sNfL. Absolute sNfL concentrations and effect sizes were not provided in the abstract.
Why it matters
This provides initial randomized trial biomarker evidence that an adapted ketogenic diet may exert neuroprotective effects against axonal damage in relapsing-remitting multiple sclerosis.
Limits
The evaluated sample size was small (n = 40 total, with only 9 control participants). It was a retrospective post-hoc analysis of trial samples rather than a prespecified primary trial outcome, and raw numerical values or effect sizes were not reported in the abstract.
Cited by
- contradicts In a clinical trial led by Markus Bock, a single seven-day cycle of a fasting-mimicking diet followed by a Mediterranean diet produced better outcomes in multiple sclerosis patients than six months of a continuous ketogenic diet.