Serum NFL discriminates Parkinson disease from atypical parkinsonisms

帕金森病 进行性核上麻痹 内科学 医学 生物标志物 胃肠病学 帕金森病 萎缩 队列 病理 疾病 生物 生物化学
作者
Tainá M. Marques,Anouke van Rumund,Patrick Oeckl,H. Bea Kuiperij,Rianne A.J. Esselink,Bastiaan R. Bloem,Markus Otto,Marcel M. Verbeek
出处
期刊:Neurology [Lippincott Williams & Wilkins]
卷期号:92 (13) 被引量:115
标识
DOI:10.1212/wnl.0000000000007179
摘要

Objective

To investigate the diagnostic value of serum neurofilament light chain (NFL) in patients with clear signs of parkinsonism but whose specific diagnosis was yet uncertain.

Methods

Serum samples were collected from patients with clear signs of parkinsonism but with uncertain diagnosis at the inclusion. Clinical diagnoses of Parkinson disease (PD) and atypical parkinsonism disorders (APDs) were established after 3 years of follow-up and updated again after a maximum of 12 years in case longer follow-up data were available. Serum NFL was quantified by single molecule array in patients with PD (n = 55) and APD (n = 29, multiple system atrophy = 22, progressive supranuclear palsy = 7) and 53 nonneurologic controls.

Results

Serum NFL levels were elevated and differentiated the APD group (mean 23.8 ± 10.3 ng/L) from PD (mean 10.4 ± 4.9 ng/L) and controls (mean 11.5 ± 6.5 ng/L, p < 0.0001) with accuracy levels up to 91% (sensitivity = 86% and specificity = 85%). Serum NFL strongly correlated with CSF NFL levels (r = 0.72, p < 0.0001) in all groups and with age in PD (r = 0.78, p < 0.0001) and controls (r = 0.66, p < 0.0001). In our cohort, the probability of having APD was 76% (positive predictive value) and of having PD 92% (negative predictive value).

Conclusion

Serum NFL levels are markedly elevated in APD compared to PD and discriminate APDs from PD with high accuracy. Serum NFL may be a useful clinical biomarker to identify APD, even at stages when clinical symptoms are not yet conclusive.

Classification of evidence

This study provides Class II evidence that serum NFL levels accurately discriminate APDs from PD.
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