Objective: We aimed to determine whether plasma NfL reflects changes in brain white matter integrity as measured using fractional anisotropy (FA) in patients with early Parkinson’s disease (PD).

Background: Neurofilament light (NfL) is a marker of axonal degeneration, whose measurement from peripheral blood was recently made possible by new assays. This new accessibility raises the possibility of clinical use in neurodegenerative disease to quantify axonal damage.

Method: We used diffusion tensor MRI to measure FA (a widely-used well-validated marker of white matter integrity) of all cerebral white matter in 177 patients with early PD (aged 67.4±9.0 years, 57.6% male, disease duration 1.1±0.7 years) and 73 healthy controls (aged 66.0±7.8 years, 46.6% male). We also gathered blood samples and measured NfL using ultrasensitive single molecule array.

Results: Higher plasma NfL concentrations were associated with lower white matter integrity (FA) in early PD after adjusting for age, sex and disease duration (Figure 1D; unstandardised β=-0.017, 95%CI=[-0.032,-0.002], p=0.027), but not in controls. The FA-NfL effect in early PD did not vary significantly with the inclusion of demographic or clinical interaction terms. There was a significant effect of language impairment on the FA-NfL association (β=0.049, p=0.030).

Conclusion: Plasma NfL does accurately reflect neuronal damage – even in early PD patients with minimal confounding by demographics or clinical factors. This implies that NfL, when measured from the peripheral blood, could indeed play a near-future role in the diagnosis and monitoring of neurodegenerative diseases including PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neurofilament-light-is-related-to-fractional-anisotropy-in-early-parkinsons-diesease/