Blood NfL Accurately Differentiates Parkinson’s Disease From Atypical Parkinsonian Disorders

Quantification of blood neurofilament light chain (NfL) concentration effectively distinguishes Parkinson’s disease from atypical parkinsonian disorders (APD), according to research published online ahead of print February 8 in Neurology. In addition, NfL in blood may also improve the diagnostic examination of patients with parkinsonian symptoms in primary and specialized settings, as well as improve treatment of axonal degeneration. It can be challenging to differentiate Parkinson’s disease from APD, especially during the early stages of the diseases. Although there are no established diagnostic methods to accurately distinguish Parkinson’s disease from APD, previous studies suggest that the NfL protein in CSF may be a reliable biomarker for APD. Several studies also indicate that CSF concentration of NfL is increased in APD, but not in Parkinson’s disease. The diagnostic utility of blood NfL had not been studied previously, however.

Oskar Hansson, MD, PhD, Associate Professor of Neurology at Lund University in Sweden, and colleagues developed an ultrasensitive single-molecule array immunoassay for NfL to determine whether levels of NfL in blood can accurately discriminate between Parkinson’s disease and APD and whether blood NfL can improve diagnostic tests for parkinsonian disorders.Three independent prospective cohorts were included in the study. The Lund cohort and the London cohort included healthy controls and patients with Parkinson’s disease, progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), and multiple system atrophy (MSA). The third cohort comprised patients with Parkinson’s disease, PSP, MSA, and CBS with disease duration of three years or less. Researchers used the ultrasensitive single-molecule array method to measure blood NfL concentration.

The investigators found a significant correlation between blood and CSF concentrations of NfL. In addition, they observed in all cohorts that blood NfL was increased in patients with MSA, PSP, and CBS, when compared with patients with Parkinson’s disease and healthy controls. Researchers concluded that blood NfL accurately differentiated Parkinson’s disease from APD in all three cohorts.

“Development of a fully automated clinical-grade assay and establishment of cutoff points would be necessary for implementation of blood-based NfL measurements in clinical practice,” said the researchers.

—Erica Tricarico

Suggested Reading

Hansson O, Janelidze S, Hall S, et al. Blood-based NfL: A biomarker for differential diagnosis of parkinsonian disorder. Neurology. 2017 Feb 8 [Epub ahead of print].

Quantification of blood neurofilament light chain (NfL) concentration effectively distinguishes Parkinson’s disease from atypical parkinsonian disorders (APD), according to research published online ahead of print February 8 in Neurology. In addition, NfL in blood may also improve the diagnostic examination of patients with parkinsonian symptoms in primary and specialized settings, as well as improve treatment of axonal degeneration. It can be challenging to differentiate Parkinson’s disease from APD, especially during the early stages of the diseases. Although there are no established diagnostic methods to accurately distinguish Parkinson’s disease from APD, previous studies suggest that the NfL protein in CSF may be a reliable biomarker for APD. Several studies also indicate that CSF concentration of NfL is increased in APD, but not in Parkinson’s disease. The diagnostic utility of blood NfL had not been studied previously, however.

Oskar Hansson, MD, PhD, Associate Professor of Neurology at Lund University in Sweden, and colleagues developed an ultrasensitive single-molecule array immunoassay for NfL to determine whether levels of NfL in blood can accurately discriminate between Parkinson’s disease and APD and whether blood NfL can improve diagnostic tests for parkinsonian disorders.Three independent prospective cohorts were included in the study. The Lund cohort and the London cohort included healthy controls and patients with Parkinson’s disease, progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), and multiple system atrophy (MSA). The third cohort comprised patients with Parkinson’s disease, PSP, MSA, and CBS with disease duration of three years or less. Researchers used the ultrasensitive single-molecule array method to measure blood NfL concentration.

The investigators found a significant correlation between blood and CSF concentrations of NfL. In addition, they observed in all cohorts that blood NfL was increased in patients with MSA, PSP, and CBS, when compared with patients with Parkinson’s disease and healthy controls. Researchers concluded that blood NfL accurately differentiated Parkinson’s disease from APD in all three cohorts.

“Development of a fully automated clinical-grade assay and establishment of cutoff points would be necessary for implementation of blood-based NfL measurements in clinical practice,” said the researchers.

—Erica Tricarico

Suggested Reading

Hansson O, Janelidze S, Hall S, et al. Blood-based NfL: A biomarker for differential diagnosis of parkinsonian disorder. Neurology. 2017 Feb 8 [Epub ahead of print].

Quantification of blood neurofilament light chain (NfL) concentration effectively distinguishes Parkinson’s disease from atypical parkinsonian disorders (APD), according to research published online ahead of print February 8 in Neurology. In addition, NfL in blood may also improve the diagnostic examination of patients with parkinsonian symptoms in primary and specialized settings, as well as improve treatment of axonal degeneration. It can be challenging to differentiate Parkinson’s disease from APD, especially during the early stages of the diseases. Although there are no established diagnostic methods to accurately distinguish Parkinson’s disease from APD, previous studies suggest that the NfL protein in CSF may be a reliable biomarker for APD. Several studies also indicate that CSF concentration of NfL is increased in APD, but not in Parkinson’s disease. The diagnostic utility of blood NfL had not been studied previously, however.

Oskar Hansson, MD, PhD, Associate Professor of Neurology at Lund University in Sweden, and colleagues developed an ultrasensitive single-molecule array immunoassay for NfL to determine whether levels of NfL in blood can accurately discriminate between Parkinson’s disease and APD and whether blood NfL can improve diagnostic tests for parkinsonian disorders.Three independent prospective cohorts were included in the study. The Lund cohort and the London cohort included healthy controls and patients with Parkinson’s disease, progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), and multiple system atrophy (MSA). The third cohort comprised patients with Parkinson’s disease, PSP, MSA, and CBS with disease duration of three years or less. Researchers used the ultrasensitive single-molecule array method to measure blood NfL concentration.

The investigators found a significant correlation between blood and CSF concentrations of NfL. In addition, they observed in all cohorts that blood NfL was increased in patients with MSA, PSP, and CBS, when compared with patients with Parkinson’s disease and healthy controls. Researchers concluded that blood NfL accurately differentiated Parkinson’s disease from APD in all three cohorts.

“Development of a fully automated clinical-grade assay and establishment of cutoff points would be necessary for implementation of blood-based NfL measurements in clinical practice,” said the researchers.

—Erica Tricarico

Suggested Reading

Hansson O, Janelidze S, Hall S, et al. Blood-based NfL: A biomarker for differential diagnosis of parkinsonian disorder. Neurology. 2017 Feb 8 [Epub ahead of print].