ArticleFrontiers in immunology2023
High levels of kappa free light chain synthesis predict cognitive decline in relapsing-remitting multiple sclerosis.
Article in Frontiers in immunology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 18 citations in OpenAlex.
- CSF κ-Free light chain index in suspected multiple sclerosis: diagnostic performance vs. Oligoclonal bands and alignment with 2017/2024 McDonald criteria.Acta neurologica Belgica · 2026Article
- Kappa Index predicts disease activity and transition to high-efficacy therapies in multiple sclerosis.Clinical chemistry and laboratory medicine · 2026Article
- Kappa Free Light Chains Reflect Treatment Response and Progression Independent of Focal Inflammation in Multiple Sclerosis.European journal of neurology · 2026Article
- The Kappa Free Light Chains Index in Multiple Sclerosis: From Emerging Evidence to Clinical Application.Journal of neurochemistry · 2026Article
- Kappa free light chain index in CSF diagnostics: the impact of different immunoglobulin isotypes.Frontiers in immunology · 2026Article
- Optimized Kappa-Index Test Protocol to Detect Intrathecal Immunoglobulin Synthesis in Multiple Sclerosis.European journal of neurology · 2025Article
- Fluid Biomarkers in Demyelinating Spectrum Disorders: Past, Present, and Prospects.International journal of molecular sciences · 2025Review
- CSF biomarkers of B-cell activation in multiple sclerosis: a clinical perspective.Journal of neurology · 2025Review
- Biomarkers of Intrathecal Synthesis May Be Associated with Cognitive Impairment at MS Diagnosis.International journal of molecular sciences · 2025Article
- Prognostic value of kappa free light chain index in patients with primary progressive multiple sclerosis.Frontiers in immunology · 2025Article
- IgG and kappa free light chain CSF/serum indices: evaluating intrathecal immunoglobulin production in HIV infection in comparison with multiple sclerosis.Clinical chemistry and laboratory medicine · 2024Article
- Cognitive impairment in multiple sclerosis: from phenomenology to neurobiological mechanisms.Journal of neural transmission (Vienna, Austria : 1996) · 2024Review
- Laboratory Diagnosis of Intrathecal Synthesis of Immunoglobulins: A Review about the Contribution of OCBs and K-index.International journal of molecular sciences · 2024Review
- Patterns of attention deficit in relapsing and progressive phenotypes of multiple sclerosis.Scientific reports · 2023Article
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Evolving evidence suggests that measurement of cerebrospinal fluid (CSF) kappa free light chain (KFLC) synthesis has high diagnostic sensitivity and specificity for multiple sclerosis (MS), but its prognostic ability is less investigated. The usefulness of KFLC in predicting cognitive impairment (CI) is still unknown. Methods: In a monocentric longitudinal retrospecitve cohort study, KFLC-index ([CSF KFLC/serum KFLC]/[CSF albumin/serum albumin]) measured by latex-enhanced immunonephelometry was prospectively determined as part of the diagnostic workup in patients with early relapsing-remitting MS (RRMS, n=77). The ability of KFLC-index to predict information processing speed (IPS) worsening as assessed with the symbol digit modalities test (SDMT) was investigated in univariable and multivariable models. Results: In patients with KFLC-index>100 (n=31), 11 subjects (35.5%) showed reduced SDMT scores by ≥8 points at follow-up (mean follow-up time 7.3 ± 2.6 years), compared with their baseline scores (p=0.01). Baseline KFLC-index>100 was strongly associated with a higher hazard of SDMT score reduction at follow-up (adjusted hazard ratio 10.5, 95% confidence interval 2.2-50.8, p=0.003; median time to SDMT reduction 7 years). Conclusion: Intrathecal KFLC synthesis has become an attractive diagnostic tool for MS. We show for the first time that in a real-world setting of early RRMS, KFLC-index predicted cognitive decline. Whether this predictive ability of KFLC-index also concerns other cognitive domains than IPS, warrants further investigations.
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