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Serum NFL discriminates Parkinson disease from atypical parkinsonisms
Open accessAbstract
Objective To investigate the diagnostic value of serum neurofilament light chain (NFL) in patients with clear signs of parkinsonism but whose specific diagnosis was yet uncertain. Methods Serum samples were collected from patients with clear signs of parkinsonism but with uncertain diagnosis at the inclusion. Clinical diagnoses of Parkinson disease (PD) and atypical parkinsonism disorders (APDs) were established after 3 years of follow-up and updated again after a maximum of 12 years in case longer follow-up data were available. Serum NFL was quantified by single molecule array in patients with PD (n = 55) and APD (n = 29, multiple system atrophy = 22, progressive supranuclear palsy = 7) and 53 nonneurologic controls. Results Serum NFL levels were elevated and differentiated the APD group (mean 23.8 ± 10.3 ng/L) from PD (mean 10.4 ± 4.9 ng/L) and controls (mean 11.5 ± 6.5 ng/L, p < 0.0001) with accuracy levels up to 91% (sensitivity = 86% and specificity = 85%). Serum NFL strongly correlated with CSF NFL levels (r = 0.72, p < 0.0001) in all groups and with age in PD (r = 0.78, p < 0.0001) and controls (r = 0.66, p < 0.0001). In our cohort, the probability of having APD was 76% (positive predictive value) and of having PD 92% (negative predictive value). Conclusion Serum NFL levels are markedly elevated in APD compared to PD and discriminate APDs from PD with high accuracy. Serum NFL may be a useful clinical biomarker to identify APD, even at stages when clinical symptoms are not yet conclusive. Classification of evidence This study provides Class II evidence that serum NFL levels accurately discriminate APDs from PD.
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Strong correlations between CSF and serum levels for NfL have been previously reported.
“We observed strong correlations between CSF and serum levels for NfL, as it has been previously reported [31, 88, 89].”
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Metadata
- Authors
- Marques, T. M., van Rumund, A., Oeckl, P., Kuiperij, H. B., Esselink, R. A. J., Bloem, B. R., Otto, M., & Verbeek, M. M.
- Affiliations
- Radboud University Nijmegen (NL)
- From the Department of Neurology (T.M.M., A.v.R., H.B.K., R.A.J.E., B.R.B., M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Laboratory Medicine (T.M.M., H.B.K., M.M.V.), Radboud University Medical Center, Nijmegen; Parkinson Center Nijmegen (T.M.M., A.v.R., R.A.J.E., B.R.B., M.M.V.), the Netherlands; and Department of Neurology (P.O., M.O.), Ulm University Hospital, Germany.
- ORCID
- Venue
- Neurology
- Published
- 2019-03-26
- Volume
- 92
- Issue
- 13
- Pages
- e1479-e1486
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2919112269
- Cited by
- 153
- References
- 45
- Citations by year
- 2026: 12 · 2025: 21 · 2024: 21 · 2023: 23 · 2022: 22 · 2021: 31 · 2020: 18 · 2019: 5
- FWCI
- 12.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Keywords
- neurofilament light chain, serum biomarkers, Parkinson's disease, atypical parkinsonism, multiple system atrophy, progressive supranuclear palsy, differential diagnosis, diagnostic accuracy
- MeSH terms
- Aged, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Parkinson Disease, Sensitivity and Specificity, Supranuclear Palsy, Progressive, Case-Control Studies, Neurofilament Proteins, Multiple System Atrophy, Parkinsonian Disorders
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