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15.05.2023 | Original Communication

Diagnostic and prognostic performance of plasma neurofilament light chain in multiple system atrophy: a cross-sectional and longitudinal study

verfasst von: Linliu Peng, Linlin Wan, Mingjie Liu, Zhe Long, Daji Chen, Xinrong Yuan, Zhichao Tang, You Fu, Sudan Zhu, Lijing Lei, Chunrong Wang, Huirong Peng, Yuting Shi, Lang He, Hongyu Yuan, Na Wan, Xuan Hou, Kun Xia, Jinchen Li, Chao Chen, Rong Qiu, Beisha Tang, Zhao Chen, Hong Jiang

Erschienen in: Journal of Neurology | Ausgabe 9/2023

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Abstract

Background

The longitudinal dynamics of neurofilament light chain (NfL) in multiple system atrophy (MSA) were incompletely illuminated. This study aimed to explore whether the plasma NfL (pNfL) could serve as a potential biomarker of clinical diagnosis and disease progression for MSA.

Methods

We quantified pNfL concentrations in both a large cross-sectional cohort with 214 MSA individuals, 65 PD individuals, and 211 healthy controls (HC), and a longitudinal cohort of 84 MSA patients. Propensity score matching (PSM) was used to balance the age between the three groups. The pNfL levels between groups were compared using Kruskal–Wallis test. Linear mixed models were performed to explore the disease progression-associated factors in longitudinal MSA cohort. Random forest model as a complement to linear models was employed to quantify the importance of predictors.

Results

Before and after matching the age by PSM, the pNfL levels could reliably differentiate MSA from HC and PD groups, but only had mild potential to distinguish PD from HC. By combining linear and nonlinear models, we demonstrated that pNfL levels at baseline, rather than the change rate of pNfL, displayed potential prognostic value for progression of MSA. The combination of baseline pNfL levels and other modifiers, such as subtypes, Hoehn–Yahr stage at baseline, was first shown to improve the diagnosis accuracy.

Conclusions

Our study contributed to a better understanding of longitudinal dynamics of pNfL in MSA, and validated the values of pNfL as a non-invasive sensitive biomarker for the diagnosis and progression. The combination of pNfL and other factors is recommended for better monitoring and prediction of MSA progression.

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Titel: Diagnostic and prognostic performance of plasma neurofilament light chain in multiple system atrophy: a cross-sectional and longitudinal study
verfasst von: Linliu Peng
Linlin Wan
Mingjie Liu
Zhe Long
Daji Chen
Xinrong Yuan
Zhichao Tang
You Fu
Sudan Zhu
Lijing Lei
Chunrong Wang
Huirong Peng
Yuting Shi
Lang He
Hongyu Yuan
Na Wan
Xuan Hou
Kun Xia
Jinchen Li
Chao Chen
Rong Qiu
Beisha Tang
Zhao Chen
Hong Jiang
Publikationsdatum: 15.05.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 9/2023
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-023-11741-y

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