Objective: The objective of the study was to analyse blood neurofilament light chain (NfL) levels in patients with Parkinson’s disease (PD) and healthy controls (HCs), and compare differences between the two groups. Samples were obtained from the East London Parkinson’s Disease (ELPD) project, a case-control study drawn from a diverse population, with a high prevalence of comorbidities such as type 2 diabetes (T2D).

Background:
Blood NfL levels in patients with PD have been shown to be elevated compared to HCs and positively correlate with worse motor outcomes [1]. T2D may be associated with a faster progression of PD motor and cognitive decline [2].

Method: Venous blood samples taken from 38 PD patients and 26 HCs were analysed for NfL levels using the Meso Scale Discovery NfL assay. 39% of PD patients also had a diagnosis of T2D. Patients were age and sex-matched (average ages: HCs = 69.8 years, PD= 67.3 years). NfL levels in the two groups were compared using the Mann-Whitney U test. A receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of the NfL assay at varying cut-offs.

Results: Plasma NfL levels in the PD group were significantly higher than in the HC group (p <0.0001), with a median NfL value of 141.9pg/ml in the PD group (95% CI: 116.6 to 186.4) and 71.1pg/ml in the HC group (95% CI: 55.1 to 81.5). ROC curve analysis yielded an AUC of 0.84 (95% CI: 0.74 to 0.94, p<0.0001). The NfL assay had a 71.1% sensitivity (95% CI: 55.2% to 83.0%) and 92.3% specificity (95% CI: 75.9% to 98.6%) at a cut-off of 107.8pg/ml for distinguishing PD patients from the controls.

Conclusion: This study provides further evidence of elevated blood NfL levels in patients with PD  compared to healthy controls and its potential use as a biomarker for PD. Further studies investigating the relationship between plasma NfL and T2D in the ELPDP cohort, as well as HbA1c levels, and the correlation of these biomarkers with cognitive and motor outcomes of PD are required to draw further conclusions.

References: [1] Mollenhauer, B. et al. (2020) ‘Validation of Serum Neurofilament Light Chain as a Biomarker of Parkinson’s Disease Progression’, Movement Disorders: Official Journal of the Movement Disorder Society, 35(11), pp. 1999–2008. doi:10.1002/mds.28206.

[2] Chohan, H. et al. (2021) ‘Type 2 Diabetes as a Determinant of Parkinson’s Disease Risk and Progression’, Movement Disorders, 36(6), pp. 1420–1429. doi:10.1002/mds.28551.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/blood-neurofilament-light-chain-as-a-biomarker-of-parkinsons-disease/