Blood NfL

Abstract

ObjectiveTo examine whether plasma neurofilament light chain (NfL) levels were associated with motor and cognitive progression in Parkinson disease (PD).MethodsThis prospective follow-up study enrolled 178 participants, including 116 with PD, 22 with multiple system atrophy (MSA), and 40 healthy controls. We measured plasma NfL levels with electrochemiluminescence immunoassay. Patients with PD received evaluations of motor and cognition at baseline and at a mean follow-up interval of 3 years. Changes in the Unified Parkinson's Disease Rating Scale (UPDRS) part III motor score and Mini-Mental State Examination score were used to assess motor and cognition progression.ResultsPlasma NfL levels were significantly higher in the MSA group than in the PD and healthy groups (35.8 ± 6.2, 17.6 ± 2.8, and 10.6 ± 2.3 pg/mL, respectively, p < 0.001). In the PD group, NfL levels were significantly elevated in patients with advanced Hoehn-Yahr stage and patients with dementia (p < 0.001). NfL levels were modestly correlated with UPDRS part III scores (r = 0.42, 95% confidence interval 0.46–0.56, p < 0.001). After a mean follow-up of 3.4 ± 1.2 years, a Cox regression analysis adjusted for age, sex, disease duration, and baseline motor or cognitive status showed that higher baseline NfL levels were associated with higher risks for either motor or cognition progression (p = 0.029 and p = 0.015, respectively).ConclusionsPlasma NfL levels correlated with disease severity and progression in terms of both motor and cognitive functions in PD.Classification of evidenceThis study provides Class III evidence that plasma NfL level distinguishes PD from MSA and is a surrogate biomarker for PD progression.

Utility of plasma Neurofilament light as a diagnostic and prognostic biomarker of the postural instability gait disorder motor subtype in early Parkinson’s disease

“…Additionally, NfL has previously shown only modest or inconsistent correlation with UPDRS Part III motor scores in PD [11,13], possibly related to the fact that the PD groups in these studies were not analysed according to motor subtype. Higher NfL levels in PD can be explained given that NfL remains a well-established biomarker of neuroaxonal loss [1], and profound dopaminergic axonal loss has been shown to occur even at early stages of PD.…”

“…Importantly, we were able to show that plasma NfL can discriminate PD from HC with high diagnostic accuracy even at early stages of the disease. NfL levels were measured in our patients at baseline, all of whom had a mean disease duration of 1.1 years at time of study recruitment, compared to other studies investigating NfL in PD which had mean disease duration ranging from 2 to 3 years [12], to 7 to 9 years [11,13].…”

“…In Parkinson's disease (PD), blood NfL has been reported to be higher in cases vs controls [9,10], and shown to be able to distinguish PD from atypical PD (APD) [11,12]. NfL has also been found to associate with longer disease duration, more aggravated motor symptoms [11], and correlate with motor and/or cognitive decline [13] in PD.…”

Characterization and Biomarker Analyses of Post-COVID-19 Complications and Neurological Manifestations

“…IL-6 and NFL correlated with increasing age only in the group of nCoV participants. Increased plasma NFL has been associated with ongoing CNS injury in HIV [47], Parkinsons [48], and AD [49]. Anti-SARS-CoV-2 IgG levels were also significantly elevated in the nCoV group compared to the CoV group.…”

What, When and How to Measure—Peripheral Biomarkers in Therapy of Huntington’s Disease

“…NFL can be determined using ultrasensitive techniques, such as immunomagnetic reduction (IMR) and the single molecule array (Simoa) in peripheral blood [53]. Results of the most recent research indicate that NFL concentration in blood is closely correlated with CSF and directly reflects neurodegeneration within the CNS in various neurodegenerative diseases, such as Parkinson's disease (PD), Alzheimer's disease (AD), frontotemporal dementia (FTD), amyotrophic lateral sclerosis (ALS), atypical parkinsonian disorders (APD), traumatic brain injury (TBI), Creutzfeldt-Jakob disease (CJD) or SCA3 [49,[54][55][56][57][58][59]. In consequence, it may lead to becoming a reliable but not disease-specific biomarker of the risk and progression of neurodegeneration [49,50,57,60].…”