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Neurofilaments in the diagnosis of motoneuron diseases: a prospective study on 455 patients

Steinacker, Petra, Feneberg, Emily, Weishaupt, Jochen, Brettschneider, Johannes, Tumani, Hayrettin, Andersen, Peter M, von Arnim, Christine A F, Böhm, Sarah, Kassubek, Jan, Kubisch, Christian, Lulé, Dorothée, Müller, Hans-Peter, Muche, Rainer, Pinkhardt, Elmar, Oeckl, Patrick, Rosenbohm, Angela, Anderl-Straub, Sarah, Volk, Alexander E, Weydt, Patrick, Ludolph, Albert C, Otto, Markus·2015·Journal of Neurology, Neurosurgery & Psychiatry

Abstract

OBJECTIVES: Biomarkers for the diagnosis of motoneuron diseases (MND) are urgently needed to improve the diagnostic pathway, patient stratification and monitoring. The aim of this study was to validate candidate markers for MND in cerebrospinal fluid (CSF) and specify cut-offs based on large patient cohorts by especially considering patients who were seen under the initial differential diagnosis (MND mimics). METHODS: In a prospective study, we investigated CSF of 455 patients for neurofilament light chain (NfL), phosphorylated heavy chain (pNfH), tau protein (Tau) and phospho-tau protein (pTau). Analysed cohorts included patients with apparently sporadic and familial amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS) (MND, n=253), MND mimics (n=85) and neurological control groups. Cut-off values were specified, and diagnostic performance and correlation with progression were analysed. RESULTS: Nfs were significantly higher in the MND group compared to the control groups, whereas Tau and pTau did not differ. At a cut-off level of 2200 pg/mL for NfL, a 77% diagnostic sensitivity (CI 71% to 82%), 85% specificity (CI 79% to 90%) and 87% positive predictive value (PPV) (CI 81% to 91%) were achieved. For pNfH, we calculated 83% sensitivity (CI 78% to 88%), 77% specificity (CI 71% to 83%) and 82% PPV (CI 77% to 86%) at 560 pg/mL. There were no significant differences between sporadic and genetic ALS or PLS. Nf levels were elevated at early disease stage, and correlated moderately with MND progression and duration. CONCLUSIONS: Neurofilaments in CSF have a high relevance for the differential diagnosis of MNDs and should be included in the diagnostic work-up of patients. Their value as prognostic markers should be investigated further.

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Metadata

Authors
Steinacker, P., Feneberg, E., Weishaupt, J., Brettschneider, J., Tumani, H., Andersen, P. M., von Arnim, C. A. F., Böhm, S., Kassubek, J., Kubisch, C., Lulé, D., Müller, H.-P., Muche, R., Pinkhardt, E., Oeckl, P., Rosenbohm, A., Anderl-Straub, S., Volk, A. E., Weydt, P., Ludolph, A. C., & Otto, M.
Venue
Journal of Neurology, Neurosurgery & Psychiatry
Publisher
BMJ
Published
2015-08-21
Volume
87
Issue
1
Pages
jnnp-2015-311387
ISSN
  • 0022-3050 (ISSN-L)
  • 1468-330X
OpenAlex
W1927582128
Cited by
317
References
9
FWCI
17.01
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Neurofilaments in the diagnosis of motoneuron diseases: a prospective study on 455 patients. https://app.cochat.ai/papers/10.1136/jnnp-2015-311387
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Steinacker, P., Feneberg, E., Weishaupt, J., Brettschneider, J., Tumani, H., Andersen, P. M., von Arnim, C. A. F., Böhm, S., Kassubek, J., Kubisch, C., Lulé, D., Müller, H.-P., Muche, R., Pinkhardt, E., Oeckl, P., Rosenbohm, A., Anderl-Straub, S., Volk, A. E., Weydt, P., . . . Otto, M. (2015). Neurofilaments in the diagnosis of motoneuron diseases: a prospective study on 455 patients. Journal of Neurology, Neurosurgery & Psychiatry. https://doi.org/10.1136/jnnp-2015-311387

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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