Blood NfL: A biomarker for disease severity and progression in Parkinson disease
Journal
Neurology
Journal Volume
93
Journal Issue
11
Pages
557
Date Issued
2019
Author(s)
Abstract
© 2019 American Academy of Neurology. OBJECTIVE: To examine whether plasma neurofilament light chain (NfL) levels were associated with motor and cognitive progression in Parkinson disease (PD). METHODS: This 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. RESULTS: Plasma 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). CONCLUSIONS: Plasma NfL levels correlated with disease severity and progression in terms of both motor and cognitive functions in PD. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that plasma NfL level distinguishes PD from MSA and is a surrogate biomarker for PD progression.
SDGs
Other Subjects
neurofilament light chain; neurofilament protein; unclassified drug; biological marker; neurofilament protein; neurofilament protein L; age; aged; area under the curve; Article; clinical evaluation; cognitive defect; controlled study; correlation analysis; cross-sectional study; diagnostic test accuracy study; disease association; disease course; disease duration; disease severity; electrochemiluminescence; female; follow up; gender; Hoehn and Yahr scale; human; major clinical study; male; Mini Mental State Examination; motor dysfunction; Parkinson disease; priority journal; prognosis; prospective study; protein blood level; receiver operating characteristic; risk assessment; sensitivity and specificity; Shy Drager syndrome; Unified Parkinson Disease Rating Scale; blood; disease exacerbation; longitudinal study; middle aged; Parkinson disease; psychology; severity of illness index; Aged; Biomarkers; Disease Progression; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Middle Aged; Neurofilament Proteins; Parkinson Disease; Prospective Studies; Severity of Illness Index
Publisher
NATURE PUBLISHING GROUP
Type
journal article