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Cerebrospinal fluid neurofilament light predicts longitudinal diagnostic change in patients with psychiatric and neurodegenerative disorders

Kang, Matthew J.Y. ; Eratne, Dhamidhu ; Dobson, Hannah ; Malpas, Charles B. ; Keem, Michael ; Lewis, Courtney ; Grewal, Jasleen ; Tsoukra, Vivian ; Dang, Christa and Mocellin, Ramon , et al. (2023) In Acta Neuropsychiatrica p.1-12
Abstract

Objective People with neuropsychiatric symptoms often experience delay in accurate diagnosis. Although cerebrospinal fluid neurofilament light (CSF NfL) shows promise in distinguishing neurodegenerative disorders (ND) from psychiatric disorders (PSY), its accuracy in a diagnostically challenging cohort longitudinally is unknown. Methods We collected longitudinal diagnostic information (mean=36 months) from patients assessed at a neuropsychiatry service, categorising diagnoses as ND/mild cognitive impairment/other neurological disorders (ND/MCI/other), and PSY. We pre-specified NfL>582pg/mL as indicative of ND/MCI/other. Results Diagnostic category changed from initial to final diagnosis for 23% (49/212) of patients. NfL predicted the... (More)

Objective People with neuropsychiatric symptoms often experience delay in accurate diagnosis. Although cerebrospinal fluid neurofilament light (CSF NfL) shows promise in distinguishing neurodegenerative disorders (ND) from psychiatric disorders (PSY), its accuracy in a diagnostically challenging cohort longitudinally is unknown. Methods We collected longitudinal diagnostic information (mean=36 months) from patients assessed at a neuropsychiatry service, categorising diagnoses as ND/mild cognitive impairment/other neurological disorders (ND/MCI/other), and PSY. We pre-specified NfL>582pg/mL as indicative of ND/MCI/other. Results Diagnostic category changed from initial to final diagnosis for 23% (49/212) of patients. NfL predicted the final diagnostic category for 92% (22/24) of these and predicted final diagnostic category overall (ND/MCI/other vs. PSY) in 88% (187/212), compared to 77% (163/212) with clinical assessment alone. Conclusions CSF NfL improved diagnostic accuracy, with potential to have led to earlier, accurate diagnosis in a real-world setting using a pre-specified cut-off, adding weight to translation of NfL into clinical practice.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
biomarker, dementia, diagnosis, diagnostic delay, neurofilament, neuropsychiatry, psychiatric disorders
in
Acta Neuropsychiatrica
pages
1 - 12
publisher
Cambridge University Press
external identifiers
  • scopus:85158049099
  • pmid:37114460
ISSN
0924-2708
DOI
10.1017/neu.2023.25
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2023 Cambridge University Press. All rights reserved.
id
7f89741c-b4e9-4871-9b9d-bf5dccef5244
date added to LUP
2023-05-20 09:52:04
date last changed
2024-02-19 19:52:24
@article{7f89741c-b4e9-4871-9b9d-bf5dccef5244,
  abstract     = {{<p>Objective People with neuropsychiatric symptoms often experience delay in accurate diagnosis. Although cerebrospinal fluid neurofilament light (CSF NfL) shows promise in distinguishing neurodegenerative disorders (ND) from psychiatric disorders (PSY), its accuracy in a diagnostically challenging cohort longitudinally is unknown. Methods We collected longitudinal diagnostic information (mean=36 months) from patients assessed at a neuropsychiatry service, categorising diagnoses as ND/mild cognitive impairment/other neurological disorders (ND/MCI/other), and PSY. We pre-specified NfL&gt;582pg/mL as indicative of ND/MCI/other. Results Diagnostic category changed from initial to final diagnosis for 23% (49/212) of patients. NfL predicted the final diagnostic category for 92% (22/24) of these and predicted final diagnostic category overall (ND/MCI/other vs. PSY) in 88% (187/212), compared to 77% (163/212) with clinical assessment alone. Conclusions CSF NfL improved diagnostic accuracy, with potential to have led to earlier, accurate diagnosis in a real-world setting using a pre-specified cut-off, adding weight to translation of NfL into clinical practice.</p>}},
  author       = {{Kang, Matthew J.Y. and Eratne, Dhamidhu and Dobson, Hannah and Malpas, Charles B. and Keem, Michael and Lewis, Courtney and Grewal, Jasleen and Tsoukra, Vivian and Dang, Christa and Mocellin, Ramon and Kalincik, Tomas and Santillo, Alexander F. and Zetterberg, Henrik and Blennow, Kaj and Stehmann, Christiane and Varghese, Shiji and Li, Qiao Xin and Masters, Colin L. and Collins, Steven and Berkovic, Samuel F. and Evans, Andrew and Kelso, Wendy and Farrand, Sarah and Loi, Samantha M. and Walterfang, Mark and Velakoulis, Dennis}},
  issn         = {{0924-2708}},
  keywords     = {{biomarker; dementia; diagnosis; diagnostic delay; neurofilament; neuropsychiatry; psychiatric disorders}},
  language     = {{eng}},
  pages        = {{1--12}},
  publisher    = {{Cambridge University Press}},
  series       = {{Acta Neuropsychiatrica}},
  title        = {{Cerebrospinal fluid neurofilament light predicts longitudinal diagnostic change in patients with psychiatric and neurodegenerative disorders}},
  url          = {{http://dx.doi.org/10.1017/neu.2023.25}},
  doi          = {{10.1017/neu.2023.25}},
  year         = {{2023}},
}