Serum Neurofilament Light Chain as a Marker of Progression in Parkinson's Disease : Long-Term Observation and Implications of Clinical Subtypes
Ygland Rödström, Emil LU ; Mattsson-Carlgren, Niklas LU ; Janelidze, Shorena LU ; Hansson, Oskar LU
and Puschmann, Andreas
LU
(2022)
In Journal of Parkinson's Disease
12(2).
p.571-584
- Abstract
Background: Biochemical and clinical biomarkers correlate with progression rate and disease severity in Parkinson's disease (PD) but are not sufficiently studied in late PD. Objective: To examine how serum neurofilament light chain (S-NfL) alone or combined with clinical classifications predicts PD outcome in later disease stages. Methods: Eighty-five patients with 7.9±5.1 years of PD duration were included in an observational cohort. Clinical scores were obtained at two separate examinations 8.2±2.0 years apart. S-NfL levels were determined with single molecule array (SiMoA). Five predefined disease progression milestones were assessed. After affirming combination potential of S-NfL and either of two clinical classifications, three... (More)
Background: Biochemical and clinical biomarkers correlate with progression rate and disease severity in Parkinson's disease (PD) but are not sufficiently studied in late PD. Objective: To examine how serum neurofilament light chain (S-NfL) alone or combined with clinical classifications predicts PD outcome in later disease stages. Methods: Eighty-five patients with 7.9±5.1 years of PD duration were included in an observational cohort. Clinical scores were obtained at two separate examinations 8.2±2.0 years apart. S-NfL levels were determined with single molecule array (SiMoA). Five predefined disease progression milestones were assessed. After affirming combination potential of S-NfL and either of two clinical classifications, three combined models were constructed based on these factors and age at onset in different combinations. Results: S-NfL levels showed significant hazard ratios for four out of five disease progression milestones: walking-aid usage (HR 3.5; 95% CI 1.4-8.5), nursing home living (5.1; 2.1-12.5), motor end-stage (6.2; 2.1-17.8), and death (4.1; 1.7-9.7). Higher S-NfL levels were associated with lower ability in activities of daily living and poorer cognition at baseline and/or at follow-up. Combined models showed significantly improved area under receiver operating characteristic curves (0.77-0.91) compared to S-NfL levels alone (0.68-0.71) for predicting the five disease milestones. Conclusion: S-NfL levels stratified patients according to their likelihood to reach clinically relevant progression milestones during this long-term observational study. S-NfL alone reflected motor and social outcomes in later stages of PD. Combining S-NfL with clinical factors was possible and exploratory combined models improved prognostic accuracy.
(Less)
- author
- Ygland Rödström, Emil
LU
; Mattsson-Carlgren, Niklas
LU
; Janelidze, Shorena
LU
; Hansson, Oskar
LU
and Puschmann, Andreas
LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- biomarkers, dementia, mortality, neurofilament proteins, Parkinson's disease, prognosis
- in
- Journal of Parkinson's Disease
- volume
- 12
- issue
- 2
- pages
- 14 pages
- publisher
- IOS Press
- external identifiers
-
- pmid:34806619
- scopus:85125000117
- ISSN
- 1877-7171
- DOI
- 10.3233/JPD-212866
- language
- English
- LU publication?
- yes
- id
- 240aa12b-58e9-46da-8da1-333f63125502
- date added to LUP
- 2022-04-12 15:48:12
- date last changed
- 2023-04-02 22:56:09
@article{240aa12b-58e9-46da-8da1-333f63125502,
abstract = {{<p>Background: Biochemical and clinical biomarkers correlate with progression rate and disease severity in Parkinson's disease (PD) but are not sufficiently studied in late PD. Objective: To examine how serum neurofilament light chain (S-NfL) alone or combined with clinical classifications predicts PD outcome in later disease stages. Methods: Eighty-five patients with 7.9±5.1 years of PD duration were included in an observational cohort. Clinical scores were obtained at two separate examinations 8.2±2.0 years apart. S-NfL levels were determined with single molecule array (SiMoA). Five predefined disease progression milestones were assessed. After affirming combination potential of S-NfL and either of two clinical classifications, three combined models were constructed based on these factors and age at onset in different combinations. Results: S-NfL levels showed significant hazard ratios for four out of five disease progression milestones: walking-aid usage (HR 3.5; 95% CI 1.4-8.5), nursing home living (5.1; 2.1-12.5), motor end-stage (6.2; 2.1-17.8), and death (4.1; 1.7-9.7). Higher S-NfL levels were associated with lower ability in activities of daily living and poorer cognition at baseline and/or at follow-up. Combined models showed significantly improved area under receiver operating characteristic curves (0.77-0.91) compared to S-NfL levels alone (0.68-0.71) for predicting the five disease milestones. Conclusion: S-NfL levels stratified patients according to their likelihood to reach clinically relevant progression milestones during this long-term observational study. S-NfL alone reflected motor and social outcomes in later stages of PD. Combining S-NfL with clinical factors was possible and exploratory combined models improved prognostic accuracy.</p>}},
author = {{Ygland Rödström, Emil and Mattsson-Carlgren, Niklas and Janelidze, Shorena and Hansson, Oskar and Puschmann, Andreas}},
issn = {{1877-7171}},
keywords = {{biomarkers; dementia; mortality; neurofilament proteins; Parkinson's disease; prognosis}},
language = {{eng}},
number = {{2}},
pages = {{571--584}},
publisher = {{IOS Press}},
series = {{Journal of Parkinson's Disease}},
title = {{Serum Neurofilament Light Chain as a Marker of Progression in Parkinson's Disease : Long-Term Observation and Implications of Clinical Subtypes}},
url = {{http://dx.doi.org/10.3233/JPD-212866}},
doi = {{10.3233/JPD-212866}},
volume = {{12}},
year = {{2022}},
}