b"brain and thalamic atrophy, greater volumethere has been signicant interest in a biomarker expansion of lesions, and clinical progression.for MS activity called neurolament light. NfL Ocrelizumab reduced NfL levels vs. controlscan be measured in the blood or spinal uid in persons with RMS and those with PPMS.andcorrelateswithdamagetothenerve Using NfL as a measure of disease progressionbers (axons) in the central nervous system. showsusefulnessinpredictingdiseaseNfL levels are elevated with acute relapses progressionandtheeffectofocrelizumaband lowered with slow progression of MS. We treatment. The ndings were published in thehave typically used MRI, relapses, and disability journal EBioMedicine.progression as markers for how effective a DMT is. This study suggests that persistently Thrower -Primary progressive MS affectslow-level elevations of NfL in PPMS may predict about 10 percent of those living with MS. It isthose not responding well to ocrelizumab. Of the one form of MS that is more common incourse,thisinformation wouldneedtobe men and typically is diagnosed later in lifeconsidered along with how the person was than relapsing forms of MS. Ocrelizumab isdoing before treatment, how fast the disability theonlyFDA-approveddisease-modifyingisprogressing,andthelackofotherFDA- therapy for PPMS. During the past few yearsapproved treatment options for PPMS.MS Focus PuzzleNo puzzleSolution to last issues puzzle:in this issue? Where's my puzzle?Do you enjoy the puzzle in each issue? Or would you rather see a new feature? Give us your feedback and suggestions at: editor@msfocus.org. Let us know what you'd like to see in each issue.msfocusmagazine.org 55"