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. 2019 May 23;90(9):1059–1067. doi: 10.1136/jnnp-2018-319190

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© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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(A) RRMS in remission versus controls (NINDCs) and (b) RRMS in relapse versus controls (HCs and NINDCs), subgroup and combined meta-analysis. (a) CSF NfL levels were higher in patients with RRMS in remission than disease controls, with a moderate effect size of 0.67; (b) CSF NfL levels were higher in patients with RRMS in relapse than both healthy and disease controls, with a large effect size of 1.13; however, heterogeneity between studies was also significant. CSF, cerebrospinal fluid; HCs, healthy controls; NfL, neurofilament light chain; MS, multiple sclerosis; NINDCs, non-inflammatory neurological disease controls; RRMS, relapsing remitting MS; SMD, standard mean deviation.