Serum and cerebrospinal neurofilament light chain levels in patients with acquired peripheral neuropathies

Abstract

Neurofilament light chain (NFL) levels reflect axonal damage in different inflammatory and neurodegenerative central nervous system conditions, in correlation with disease severity. Our aim was to determine the possible diagnostic and prognostic value of serum and cerebrospinal fluid (CSF) NFL levels in subjects with different forms of acquired peripheral neuropathies (PN). Paired serum and CSF samples of 25 patients with acquired PN were analysed for NFL using an ultrasensitive technique (Quanterix, Simoa, Lexington, MA, USA) and compared with a group of 25 age-matched healthy subjects. Demographic, clinical, CSF and neurophysiological data were reviewed. Cases with Guillain-Barré syndrome (N = 5), multifocal motor neuropathy (N = 3), chronic inflammatory demyelinating polyneuropathy (CIDP) and variants (N = 12), anti-myelin-associated glycoprotein (MAG) neuropathy (N = 3), both CIDP and anti-MAG neuropathy (N = 1), and non-systemic vasculitic neuropathy (N = 1) were studied. NFL levels were significantly (P < 0.001) increased in patients with PN and were higher in the CSF (median: 1407 pg/mL, range: 140.2-12 661) than in serum (median: 31.52 pg/mL, range: 4.33-1178). A statistically significant correlation was observed between serum and CSF levels in cases with blood-nerve-barrier damage (r = 0.71, P < 0.01), and between serum NFL levels and disease activity at sampling (r = 0.52, P < 0.01) and at last follow-up (r = 0.53, P < 0.01) in all subjects. The increase of NFL values in both serum and CSF of patients with acquired PN and the significant correlation between serum NFL levels, disease severity and final outcome support the possible role of NFL as disease activity and prognostic biomarker also in peripheral nervous system disorders.

Serum neurofilament light chain in chronic inflammatory demyelinating polyneuropathy

“…We found a correlation between sNfL levels and axonal damage assessed with NCS in CIDP patients starting IT (Figure ) in line with previous findings of sNfL levels being a reflection of neuro‐axonal damage . The correlation in our study was, however, no longer significant when corrected for age, which may be explained by the relatively small number of NCS.…”

“…A recent small pilot study found a correlation between increased levels of sNfL and disability, using the overall neuropathy limitation scale, in patients with various acquired peripheral neuropathies including 12 CIDP patients, although specific results for CIDP patients were not reported . In our study, we did not find a correlation between sNfL levels and disability in the IT cohort at baseline.…”

“…Studies in various neurological disorders have shown that neurofilament light chain (NfL) is a biomarker of axonal damage and may function as a biomarker for disease activity also in demyelinating disorders such as multiple sclerosis . A recent pilot study showed increased levels of serum and cerebrospinal fluid NfL levels in various acquired peripheral neuropathies . The role of NfL as a biomarker of axonal damage and disease activity in CIDP was not investigated.…”

“…[7][8][9] A recent pilot study showed increased levels of serum and cerebrospinal fluid NfL levels in various acquired peripheral neuropathies. 10 The role of NfL as a biomarker of axonal damage and disease activity in CIDP was not investigated.…”

Peripheral nervous system involvement in lymphomas

“…Hopefully, in the nearby future, new diagnostic tools may become available. Recently, attention has been paid to neurofilament light chain as potential marker of peripheral nerve damage both in the preclinical and clinical setting . A possible diagnostic and prognostic role of neurofilaments in the polyneuropathies workup is currently under investigation.…”