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Clinical Autonomic Research
Erschienen in: Clinical Autonomic Research 6/2023

21.08.2023 | Research Article

Neurofilament light chain in spinal fluid and plasma in multiple system atrophy: a prospective, longitudinal biomarker study

verfasst von: Wolfgang Singer, Ann M. Schmeichel, David M. Sletten, Tonette L. Gehrking, Jade A. Gehrking, Jorge Trejo-Lopez, Mariana D. Suarez, Jennifer K. Anderson, Pamela H. Bass, Timothy G. Lesnick, Phillip A. Low

Erschienen in: Clinical Autonomic Research | Ausgabe 6/2023

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Abstract

Purpose

There is a critical need for reliable diagnostic biomarkers as well as surrogate markers of disease progression in multiple system atrophy (MSA). Neurofilament light chain (NfL) has been reported to potentially meet those needs. We therefore sought to explore the value of NfL in plasma (NfL-p) in contrast to cerebrospinal fluid (NfL-c) as a diagnostic marker of MSA, and to assess NfL-p and NfL-c as markers of clinical disease progression.

Methods

Well-characterized patients with early MSA (n = 32), Parkinson’s disease (PD; n = 21), and matched controls (CON; n = 15) were enrolled in a prospective, longitudinal study of synucleinopathies with serial annual evaluations. NfL was measured using a high-sensitivity immunoassay, and findings were assessed by disease category and relationship with clinical measures of disease progression.

Results

Measurements of NfL-c were highly reproducible across immunoassay platforms (Pearson, r = 0.99), while correlation between NfL-c and -p was only moderate (r = 0.66). NfL was significantly higher in MSA compared with CON and PD; the separation was essentially perfect for NfL-c, but there was overlap, particularly with PD, for NfL-p. While clinical measures of disease severity progressively increased over time, NfL-c and -p remained at stable elevated levels within subjects across serial measurements. Neither change in NfL nor baseline NfL were significantly associated with changes in clinical markers of disease severity.

Conclusions

These findings confirm NfL-c as a faithful diagnostic marker of MSA, while NfL-p showed less robust diagnostic value. The significant NfL elevation in MSA was found to be remarkably stable over time and was not predictive of clinical disease progression.
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Metadaten
Titel
Neurofilament light chain in spinal fluid and plasma in multiple system atrophy: a prospective, longitudinal biomarker study
verfasst von
Wolfgang Singer
Ann M. Schmeichel
David M. Sletten
Tonette L. Gehrking
Jade A. Gehrking
Jorge Trejo-Lopez
Mariana D. Suarez
Jennifer K. Anderson
Pamela H. Bass
Timothy G. Lesnick
Phillip A. Low
Publikationsdatum
21.08.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 6/2023
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-023-00974-6

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