Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurologic Diseases

MedicalResearch.com Interview with:

Charlotte E. Teunissen,

Prof. Teunissen

Charlotte E. Teunissen, PhD
Neurochemistry Laboratory, Department of Clinical Chemistry
VU University Medical Centre, Neuroscience Campus Amsterdam
Amsterdam, the Netherlands

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Several reports have shown increased in NfL in various neurological disorders, separately. We wanted to know how the levels are in these disorders relative to each other. Moreover, some reports showed absence of age effects in Multiple Sclerosis (MS) patients, which is normally present in controls. So, we thought that it would be good to study age effects in a large group of controls, and if these effects are absent in other diseases, similarly as in MS.

MedicalResearch.com: What should readers take away from your report?

Response: That the highest levels are found in HIV dementia, frontotemporal dementia (FTD) /amyotrophic lateral sclerosis (ALS), ALS and Huntington’s diseases. And that age effects are absent in some, but surely not all, neurological diseases, such as MS, FTD (among the dementias) and MSA (among the atypical Parkinsonisms). 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Now it is time to establish cut-offs for specific diagnostic categories. We need to study which are the age-intervals to make such cut-offs: decades in younger age, and maybe per 5 years in older age (when there is a stronger increase, given the log-scale)? That needs to be studied in terms of clinical relevance (diagnosis of Alzheimer’s Disease at age 75 is more frequent than in MS patients).

Moreover, we would like to understand the variation observed even in the control groups: is that preclinical neurological damage and might that have future implications? We should also study if the same age relationships (and lack of them) are present in serum or plasma levels of NfL.

And needless to say that age should always be taken into account as confounder.

MedicalResearch.com: Is there anything else you would like to add?

Response: No disclosures other than in the paper. The study was only possible due to the active participation and interest of many study groups, willing to share their individual level patient data.

Citation:

Bridel C, van Wieringen WN, Zetterberg H, Tijms BM, Teunissen CE, and the NFL Group. Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology: A Systematic Review and Meta-analysis. JAMA Neurol. Published online June 17, 2019. doi:10.1001/jamaneurol.2019.1534

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