There is evidence of a relationship between pro-myelinating proteins and clinical MS activity during clinical relapse or recovery from clinical relapses.

Examine the linkage between pro-myelinating biomarkers and volumetric changes in multiple sclerosis (MS) subjects during serial magnetic resonance (MR) imaging.

We enrolled 13 MS subjects with active brain MRI scans not on disease modifying therapies (DMTs). Subjects underwent baseline MRI, serum and CSF sampling.  Qualitative changes; new/resolving Gd, new/enlarging/diminishing T2 and T1 hypointense lesions were compared to baseline in subsequent MRI scans, and volumetric analysis was calculated. Analysis of biomarkers on serial CSF samples was performed only in subjects with qualitative (and quantitative) changes on MRI. 

There was increased CSF N-CAM during increased qualitative T1 activity. A positive correlation between CSF and serum N-CAM and T1 lesion volume was observed.   A negative correlation between serum BDNF and BPH and T1 lesion volume was observed.  

Increased N-CAM levels may be related to repair or re-myelination following injury to the brain as shown by increased T1 volumes. Our data suggest an early kind of blood signaling that induces release of peripheral BDNF levels.