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Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Neurology 2015 ; 84 (22): 2247-57 Nephropedia Template TP
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Neurofilament light chain: A prognostic biomarker in amyotrophic lateral sclerosis #MMPMID25934855
Lu CH; Macdonald-Wallis C; Gray E; Pearce N; Petzold A; Norgren N; Giovannoni G; Fratta P; Sidle K; Fish M; Orrell R; Howard R; Talbot K; Greensmith L; Kuhle J; Turner MR; Malaspina A
Neurology 2015[Jun]; 84 (22): 2247-57 PMID25934855show ga
Objective:: To test blood and CSF neurofilament light chain (NfL) levels in relation to disease progression and survival in amyotrophic lateral sclerosis (ALS). Methods:: Using an electrochemiluminescence immunoassay, NfL levels were measured in samples from 2 cohorts of patients with sporadic ALS and healthy controls, recruited in London (ALS/control, plasma: n = 103/42) and Oxford (ALS/control, serum: n = 64/36; paired CSF: n = 38/20). NfL levels in patients were measured at regular intervals for up to 3 years. Change in ALS Functional Rating Scale?Revised score was used to assess disease progression. Survival was evaluated using Cox regression and Kaplan?Meier analysis. Results:: CSF, serum, and plasma NfL discriminated patients with ALS from healthy controls with high sensitivity (97%, 89%, 90%, respectively) and specificity (95%, 75%, 71%, respectively). CSF NfL was highly correlated with serum levels (r = 0.78, p < 0.0001). Blood NfL levels were approximately 4 times as high in patients with ALS compared with controls in both cohorts, and maintained a relatively constant expression during follow-up. Blood NfL levels at recruitment were strong, independent predictors of survival. The highest tertile of blood NfL at baseline had a mortality hazard ratio of 3.91 (95% confidence interval 1.98?7.94, p < 0.001). Conclusion:: Blood-derived NfL level is an easily accessible biomarker with prognostic value in ALS. The individually relatively stable levels longitudinally offer potential for NfL as a pharmacodynamic biomarker in future therapeutic trials. Classification of evidence:: This report provides Class III evidence that the NfL electrochemiluminescence immunoassay accurately distinguishes patients with sporadic ALS from healthy controls.
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Neurology 2015 ; 84 (22): 2247-57
