A multicentre validation study of the diagnostic value of plasma neurofilament light

Nat Commun. 2021 Jun 7;12(1):3400. doi: 10.1038/s41467-021-23620-z.

Abstract

Increased cerebrospinal fluid neurofilament light (NfL) is a recognized biomarker for neurodegeneration that can also be assessed in blood. Here, we investigate plasma NfL as a marker of neurodegeneration in 13 neurodegenerative disorders, Down syndrome, depression and cognitively unimpaired controls from two multicenter cohorts: King's College London (n = 805) and the Swedish BioFINDER study (n = 1,464). Plasma NfL was significantly increased in all cortical neurodegenerative disorders, amyotrophic lateral sclerosis and atypical parkinsonian disorders. We demonstrate that plasma NfL is clinically useful in identifying atypical parkinsonian disorders in patients with parkinsonism, dementia in individuals with Down syndrome, dementia among psychiatric disorders, and frontotemporal dementia in patients with cognitive impairment. Data-driven cut-offs highlighted the fundamental importance of age-related clinical cut-offs for disorders with a younger age of onset. Finally, plasma NfL performs best when applied to indicate no underlying neurodegeneration, with low false positives, in all age-related cut-offs.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Age Factors
  • Aged
  • Biomarkers / cerebrospinal fluid
  • Cognitive Dysfunction / cerebrospinal fluid
  • Cognitive Dysfunction / diagnosis*
  • Cohort Studies
  • Depression / cerebrospinal fluid
  • Depression / diagnosis*
  • Down Syndrome / cerebrospinal fluid
  • Down Syndrome / diagnosis*
  • False Positive Reactions
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurodegenerative Diseases / cerebrospinal fluid
  • Neurodegenerative Diseases / diagnosis*
  • Neurofilament Proteins / cerebrospinal fluid*
  • Predictive Value of Tests
  • Reference Values
  • Sex Factors

Substances

  • Biomarkers
  • Neurofilament Proteins
  • neurofilament protein L