Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
Plasma and CSF neurofilament light chain distinguish neurodegenerative from primary psychiatric conditions in a clinical setting.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Eratne Dhamidhu, Kang Matthew J Y, Lewis Courtney, Dang Christa, Malpas Charles B, Keem Michael, Grewal Jasleen, Marinov Vladimir, Coe Amy, Kaylor-Hughes Cath, Borchard Thomas, Keng-Hong Chhoa, Waxmann Alexandra, Saglam Burcu, Kalincik Tomas, Kanaan Richard, Kelso Wendy, Evans Andrew, Farrand Sarah, Loi Samantha, Walterfang Mark, Stehmann Christiane, Li Qiao-Xin, Collins Steven, Masters Colin L, Santillo Alexander F, Zetterberg Henrik, Blennow Kaj, Berkovic Samuel F, Velakoulis Dennis, MiND Study Group
Аннотация
INTRODUCTION: People with neurodegenerative disorders (ND) frequently face diagnostic delay and misdiagnosis. We investigated blood and cerebrospinal fluid (CSF) neurofilament light chain (NfL) to distinguish ND from primary psychiatric disorders (PPD), a common challenge in clinical settings.
METHODS: Plasma and CSF NfL levels were measured and compared between groups, adjusting for age, sex, and weight.
RESULTS: A total of 337 participants were included: 136 ND, 77 PPD, and 124 Controls. Plasma NfL was 2.5-fold elevated in ND compared to PPD and had strong diagnostic performance (area under the curve, [AUC]: 0.86, 81%/85% specificity/sensitivity) that was comparable to CSF NfL (2-fold elevated, AUC: 0.89, 95%/71% specificity/sensitivity). Diagnostic performance was especially strong in younger people (40- < 60 years). Additional findings were cutoffs optimized for sensitivity and specificity, and issues important for future clinical translation.
CONCLUSIONS: This study adds important evidence for a simple blood-based biomarker to assist as a screening test for neurodegeneration and distinction from PPD, in clinical settings.
HIGHLIGHTS: NfL levels were significantly higher in ND versus PPD. Plasma NfL showed strong diagnostic performance, comparable to CSF NfL, to distinguish ND from PPD. Diagnostic performance was higher in younger people, where diagnostic challenges are greater. Further research is needed on analytical and reference range factors, for clinical translation. These findings support a simple screening blood test for neurodegeneration.
METHODS: Plasma and CSF NfL levels were measured and compared between groups, adjusting for age, sex, and weight.
RESULTS: A total of 337 participants were included: 136 ND, 77 PPD, and 124 Controls. Plasma NfL was 2.5-fold elevated in ND compared to PPD and had strong diagnostic performance (area under the curve, [AUC]: 0.86, 81%/85% specificity/sensitivity) that was comparable to CSF NfL (2-fold elevated, AUC: 0.89, 95%/71% specificity/sensitivity). Diagnostic performance was especially strong in younger people (40- < 60 years). Additional findings were cutoffs optimized for sensitivity and specificity, and issues important for future clinical translation.
CONCLUSIONS: This study adds important evidence for a simple blood-based biomarker to assist as a screening test for neurodegeneration and distinction from PPD, in clinical settings.
HIGHLIGHTS: NfL levels were significantly higher in ND versus PPD. Plasma NfL showed strong diagnostic performance, comparable to CSF NfL, to distinguish ND from PPD. Diagnostic performance was higher in younger people, where diagnostic challenges are greater. Further research is needed on analytical and reference range factors, for clinical translation. These findings support a simple screening blood test for neurodegeneration.