Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Plasma and CSF neurofilament light chain distinguish neurodegenerative from primary psychiatric conditions in a clinical setting

Eratne, Dhamidhu ; Kang, Matthew J.Y. ; Lewis, Courtney ; Dang, Christa ; Malpas, Charles B. ; Keem, Michael ; Grewal, Jasleen ; Marinov, Vladimir ; Coe, Amy and Kaylor-Hughes, Cath , et al. (2024) In Alzheimer's and Dementia 20(11). p.7989-8001
Abstract

INTRODUCTION: People with neurodegenerative disorders (ND) frequently face diagnostic delay and misdiagnosis. We investigated blood and cerebrospinal fluid (CSF) neurofilament light chain (NfL) to distinguish ND from primary psychiatric disorders (PPD), a common challenge in clinical settings. METHODS: Plasma and CSF NfL levels were measured and compared between groups, adjusting for age, sex, and weight. RESULTS: A total of 337 participants were included: 136 ND, 77 PPD, and 124 Controls. Plasma NfL was 2.5-fold elevated in ND compared to PPD and had strong diagnostic performance (area under the curve, [AUC]: 0.86, 81%/85% specificity/sensitivity) that was comparable to CSF NfL (2-fold elevated, AUC: 0.89, 95%/71%... (More)

INTRODUCTION: People with neurodegenerative disorders (ND) frequently face diagnostic delay and misdiagnosis. We investigated blood and cerebrospinal fluid (CSF) neurofilament light chain (NfL) to distinguish ND from primary psychiatric disorders (PPD), a common challenge in clinical settings. METHODS: Plasma and CSF NfL levels were measured and compared between groups, adjusting for age, sex, and weight. RESULTS: A total of 337 participants were included: 136 ND, 77 PPD, and 124 Controls. Plasma NfL was 2.5-fold elevated in ND compared to PPD and had strong diagnostic performance (area under the curve, [AUC]: 0.86, 81%/85% specificity/sensitivity) that was comparable to CSF NfL (2-fold elevated, AUC: 0.89, 95%/71% specificity/sensitivity). Diagnostic performance was especially strong in younger people (40– < 60 years). Additional findings were cutoffs optimized for sensitivity and specificity, and issues important for future clinical translation. CONCLUSIONS: This study adds important evidence for a simple blood-based biomarker to assist as a screening test for neurodegeneration and distinction from PPD, in clinical settings. Highlights: NfL levels were significantly higher in ND versus PPD. Plasma NfL showed strong diagnostic performance, comparable to CSF NfL, to distinguish ND from PPD. Diagnostic performance was higher in younger people, where diagnostic challenges are greater. Further research is needed on analytical and reference range factors, for clinical translation. These findings support a simple screening blood test for neurodegeneration.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
biomarkers, dementia, diagnosis, neurofilament light chain protein, psychiatric disorders
in
Alzheimer's and Dementia
volume
20
issue
11
pages
7989 - 8001
publisher
Wiley
external identifiers
  • pmid:39369278
  • scopus:85205663571
ISSN
1552-5260
DOI
10.1002/alz.14278
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
id
3752119f-384a-4447-a1e7-4a65bb3f8cef
date added to LUP
2024-10-14 09:42:14
date last changed
2025-07-08 08:05:10
@article{3752119f-384a-4447-a1e7-4a65bb3f8cef,
  abstract     = {{<p>INTRODUCTION: People with neurodegenerative disorders (ND) frequently face diagnostic delay and misdiagnosis. We investigated blood and cerebrospinal fluid (CSF) neurofilament light chain (NfL) to distinguish ND from primary psychiatric disorders (PPD), a common challenge in clinical settings. METHODS: Plasma and CSF NfL levels were measured and compared between groups, adjusting for age, sex, and weight. RESULTS: A total of 337 participants were included: 136 ND, 77 PPD, and 124 Controls. Plasma NfL was 2.5-fold elevated in ND compared to PPD and had strong diagnostic performance (area under the curve, [AUC]: 0.86, 81%/85% specificity/sensitivity) that was comparable to CSF NfL (2-fold elevated, AUC: 0.89, 95%/71% specificity/sensitivity). Diagnostic performance was especially strong in younger people (40– &lt; 60 years). Additional findings were cutoffs optimized for sensitivity and specificity, and issues important for future clinical translation. CONCLUSIONS: This study adds important evidence for a simple blood-based biomarker to assist as a screening test for neurodegeneration and distinction from PPD, in clinical settings. Highlights: NfL levels were significantly higher in ND versus PPD. Plasma NfL showed strong diagnostic performance, comparable to CSF NfL, to distinguish ND from PPD. Diagnostic performance was higher in younger people, where diagnostic challenges are greater. Further research is needed on analytical and reference range factors, for clinical translation. These findings support a simple screening blood test for neurodegeneration.</p>}},
  author       = {{Eratne, Dhamidhu and Kang, Matthew J.Y. and Lewis, Courtney and Dang, Christa and Malpas, Charles B. and Keem, Michael and Grewal, Jasleen and Marinov, Vladimir and Coe, Amy and Kaylor-Hughes, Cath and Borchard, Thomas and Keng-Hong, Chhoa and Waxmann, Alexandra and Saglam, Burcu and Kalincik, Tomas and Kanaan, Richard and Kelso, Wendy and Evans, Andrew and Farrand, Sarah and Loi, Samantha and Walterfang, Mark and Stehmann, Christiane and Li, Qiao Xin and Collins, Steven and Masters, Colin L. and Santillo, Alexander F. and Zetterberg, Henrik and Blennow, Kaj and Berkovic, Samuel F. and Velakoulis, Dennis}},
  issn         = {{1552-5260}},
  keywords     = {{biomarkers; dementia; diagnosis; neurofilament light chain protein; psychiatric disorders}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{7989--8001}},
  publisher    = {{Wiley}},
  series       = {{Alzheimer's and Dementia}},
  title        = {{Plasma and CSF neurofilament light chain distinguish neurodegenerative from primary psychiatric conditions in a clinical setting}},
  url          = {{http://dx.doi.org/10.1002/alz.14278}},
  doi          = {{10.1002/alz.14278}},
  volume       = {{20}},
  year         = {{2024}},
}