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neurofilament light chain in serum/plasma

Indications: - identification of clinical relapse in multiple sclerosis - prognosis after cardiac arrest [2] - prognosis in patients with Guillain-Barre syndrome [6] - may be elevated in the early chronic phase of traumatic brain injury [10] - evaluation of dementia Pathology: - marker of axonal damage [8] Clinical significance: - serum levels significantly higher in patients with MRI- confirmed subclinical multiple sclerosis disease activity - serum neurofilament light chain at 24 hours after cardiac arrest predicts long-term poor neurologic outcome [2] - serum levels higher in multiple system atrophy or progressive supranuclear palsy than in Parkinson's disease & healthy controls - levels in plasma correspond with hallmarks of Alzheimer's disease progression [4] - levels in plasma predict onset of MCI in familial Alzheimer's disease type 3 3 years prior [5] - plasma levels are elevated in frontotemporal dementia & in Alzheimer's disease [7] - plasma levels cannot distinguish frontotemporal dementia from Alzheimer's disease [7] - predicts future dementia risk in cerebral small vessel disease [8] - strongly associated with brain atrophy in multiple areas, white matter alterations, & changes in global cognition [9] - higher plasma NfL is associated with higher risk of cardiovascular disease, mortality from heart failure, & kidney disease [11] - 5x higher concentrations of serum NfL associated with increased risk of overall mortality (RR=2.13) [12]

Related

neurofilament light polypeptide; NF-L; neurofilament triplet L protein; 68 kD neurofilament protein (NEFL, NF68, NFL)

General

neurofilament light chain in body fluid

References

  1. Jenkins K Serum Biomarker May Predict Relapse in MS High NF-L levels could identify subclinical disease activity. MedPage Today. Nov 30, 2017 - Varhaug KN, Barro C, Bjornevik K et al Neurofilament light chain predicts disease activity in relapsing-remitting MS Neurol. Published Online Nov 29, 2017 PMID: 29209636 http://nn.neurology.org/content/5/1/e422
  2. Moseby-Knappe M, Mattsson N, Nielsen N et al Serum Neurofilament Light Chain for Prognosis of Outcome After Cardiac Arrest. JAMA Neurol. Published online October 29, 2018. PMID: 30383090 https://jamanetwork.com/journals/jamaneurology/fullarticle/2709115
  3. Marques TM, van Rumund A, Oeckl P et al. Serum NFL discriminates Parkinson disease from atypical parkinsonisms. Neurology. 2019 Mar 26;92(13):e1479-e1486 ePub: Feb 27 2019 PMID: 30814322 https://n.neurology.org/content/92/13/e1479
  4. George J Blood Test Tracks Alzheimer's Progression. https://www.medpagetoday.com/neurology/alzheimersdisease/79366 - Mattsson N, Cullen NC, Andreasson U et al Association Between Longitudinal Plasma Neurofilament Light and Neurodegeneration in Patients With Alzheimer Disease. JAMA Neurol. Published online April 22, 2019. PMID: 31009028 https://jamanetwork.com/journals/jamaneurology/article-abstract/2731440
  5. Quiroz YT et al. Plasma neurofilament light chain in the presenilin 1 E280A autosomal dominant Alzheimer's disease kindred: A cross-sectional and longitudinal cohort study. Lancet Neurol 2020 Jun; 19:513. PMID: 32470423 https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(20)30137-X/fulltext
  6. George J Blood Biomarker Predicts Guillain-Barre Outcomes - Neurofilament light may help monitor disease severity, help improve prognosis. MedPage Today November 13, 2020 httpi://www.medpagetoday.com/neurology/generalneurology/89669 - Martin-Aguilar L, et al Serum neurofilament light chain predicts long-term prognosis in Guillain-Barre syndrome patients. J Neurol Neurosurg Psychiatry 2020 PMID: 33154183 https://jnnp.bmj.com/content/early/2020/11/05/jnnp-2020-323899 - Jacobs BC Neurofilament light chain as biomarker for axonal damage in Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 2020 PMID: 33154185 https://jnnp.bmj.com/content/early/2020/11/05/jnnp-2020-324308
  7. Illan-Gala I, Lleo A, Karydas A et al Plasma tau and neurofilament light in frontotemporal lobar degeneration and Alzheimer's disease. Neurology 2020 Nov 16; [e-pub]. PMID: 33199433 https://n.neurology.org/content/96/5/e671
  8. Egle M, Loubiere L, Maceski A et al Neurofilament light chain predicts future dementia risk in cerebral small vessel disease. J Neurol Neurosurg Psychiatry. Feb 8, 2021 PMID: 33558370 https://jnnp.bmj.com/content/early/2021/02/08/jnnp-2020-325681.info
  9. George J Blood-Based Markers Tied to Brain Cell and Memory Loss. Another step closer to clinical utility for tracking neurodegeneration. MedPage Today April 16, 2021 https://www.medpagetoday.com/meetingcoverage/aan/92140 - Marks J, et al Comparison of neurofilament light and total tau as blood-based biomarkers of neurodegeneration: associations with cognition and neuroimaging outcomes. American Academy of Neurology (AAN) 2021.
  10. Newcombe VFJ et al. Post-acute blood biomarkers and disease progression in traumatic brain injury. Brain 2022 Apr 4; [e-pub] PMID: 35377407 https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awac126/6563212
  11. Dark HE, Paterson C, Daya GN et al Proteomic Indicators of Health Predict Alzheimer's Disease Biomarker Levels and Dementia Risk. Ann Neurol. 2023. Oct 6. PMID: 37801487 https://onlinelibrary.wiley.com/doi/full/10.1002/ana.26817
  12. Halloway S et al Serum total tau, neurofilament light, and glial fibrillary acidic protein are associated with mortality in a population study. J Am Geriatr Soc. 2024 Jan;72(1):149-159 PMID: 37818793 https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.18632