Tackling the usefulness of neurofilament light chain in multiple system atrophy: diagnostic and prognostic perspectives

Excerpt

Multiple system atrophy (MSA) is a rapidly progressive fatal neurodegenerative disease characterized by parkinsonism and/or cerebellar ataxia accompanied by cardiovascular and urogenital autonomic dysfunction, with no available disease-modifying treatments to date [1]. Among the many challenges in the field, obtaining a reliable biomarker for diagnostic and prognostic purposes remains a challenge. This also leads to significant difficulty in objectively characterizing disease progression in MSA, and potentially evaluating treatment response for prospective disease-modifying therapies. Several biomarkers have been explored in the recent past, with neurofilament light chain (NfL) being a potential candidate due to its association with rapid disease progression or a significant amount of neuronal injury. As a marker of axonal degeneration, both plasma and cerebral spinal fluid (CSF) concentrations of NfL have been described as potentially useful in distinguishing MSA from other parkinsonian syndromes, such as Parkinson’s disease (PD). Additionally, a large multicenter European study by Chelban et al. demonstrated that plasma NfL (NfL-p) could be useful in tracking MSA progression, and correlated with survival [2]. …