Objective: To assess the value of serum neurofilament light chain (NFL) levels in differentiating parkinsonian syndromes.

Background: The diagnosis of Parkinson’s disease (PD) mostly relies on clinical symptoms. In early disease stages it can be clinically difficult to diagnose and differentiate idiopathic PD from Multiple System Atrophy- Parkinsonism (MSA-P) and Parkinsonism predominated Progressive Supranuclear Palsy (PSP-P). Therefore, in the management of PD, with respect to early diagnosis, reliable biomarkers are urgently needed.

Method: A prospective, longitudinal cohort of 49 patients and 16 control participants were recruited from a single tertiary care center. Patients were clinically diagnosed according to current consensus criteria. Serum samples were obtained from patients with clinical diagnoses of 19 patients with PD, 15 with MSA-Parkinsonism and 15 with PSP-P. Sixteen healthy, elderly participants were included as controls. Serum NFL levels were measured using NFL sandwich enzyme-linked immunosorbent assay.

Results: Serum levels of NFL were significantly increased in PD (P< 0.0001) and MSA-P (P< 0.0001) compared to either healthy controls or PSP-P, whereas, there was no change in NFL levels in PSP-P (P>0.1) compared to healthy controls. Optimal discriminative cut-off value for the differentiation between PD and PSP-P was calculated resulting in high sensitivity (68–99%) and specificity (82–100%).

Conclusion: Serum NFL is under investigation because it would provide a non-invasive tool, both for early and differential diagnosis of PD versus atypical parkinsonian disorder. Differentiating PD from PSP-P could be accurately possible with serum analysis of NFL, but not from the MSA-P. In view of adopting serum biomarkers for improving PD diagnostic and prognostic accuracy, further validation in large independent cohorts is required.

References: 1: Blood-based NfL: A biomarker for differential diagnosis of parkinsonian disorder Oskar Hansson, Shorena Janelidze, Sara Hall, Nadia Magdalinou, Andrew J. Lees, Ulf Andreasson, Niklas Norgren, Jan Linder, Lars Forsgren, Radu Constantinescu, Henrik Zetterberg, Kaj Blennow, For the Swedish BioFINDER study Neurology. 2017 Mar 7; 88(10): 930–937. doi: 10.1212/WNL.0000000000003680. PMCID: PMC5333515 2: Plasma neurofilament light chain predicts progression in progressive supranuclear palsy. Julio C. Rojas, Anna Karydas, Jee Bang, Richard M. Tsai, Kaj Blennow, Victor Liman, Joel H. Kramer, Howard Rosen, Bruce L. Miller, Henrik Zetterberg, Adam L. Boxer. Ann Clin Transl Neurol. 2016 Mar; 3(3): 216–225. Published online 2016 Feb 1. doi: 10.1002/acn3.290. PMCID: PMC4774256 3: CSF neurofilament concentration reflects disease severity in frontotemporal degeneration. Carole S. Scherling, Tracey Hall, Flora Berisha, Kristen Klepac, Anna Karydas, Giovanni Coppola, Joel H. Kramer, Gil Rabinovici, Michael Ahlijanian, Bruce L. Miller, William Seeley, Lea T. Grinberg, Howard Rosen, Jere Meredith, Jr., Adam L. Boxer. Ann Neurol. Author manuscript; available in PMC 2014 May 14.Published in final edited form as: Ann Neurol. 2014 Jan; 75(1): 116–126. Published online 2014 Jan 2. doi: 10.1002/ana.24052. PMCID: PMC4020786 4: Clinical value of neurofilament and phospho-tau/tau ratio in the frontotemporal dementia spectrum. Lieke H.H. Meeter, Everard G. Vijverberg, Marta Del Campo, Annemieke J.M. Rozemuller, Laura Donker Kaat, Frank Jan de Jong, Wiesje M. van der Flier, Charlotte E. Teunissen, John C. van Swieten, Yolande A.L. Pijnenburg Neurology. 2018 Apr 3; 90(14): e1231–e1239. doi: 10.1212/WNL.0000000000005261. PMCID: PMC5890612 5: New diagnostics and therapeutics for progressive supranuclear palsy. Adam L. Boxer, Jin-Tai Yu, Lawrence I Golbe, Irene Litvan, Anthony E Lang, Günter U Höglinger Lancet Neurol. Author manuscript; available in PMC 2018 Feb 7.Published in final edited form as: Lancet Neurol. 2017 Jul; 16(7): 552–563. Published online 2017 Jun 13. doi: 10.1016/S1474-4422(17)30157-6. PMCID: PMC5802400

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MDS Abstracts - https://www.mdsabstracts.org/abstract/serum-neurofilament-light-chain-differentiates-early-parkinsons-disease-from-progressive-supranuclear-palsy-parkinsonism/