Objective: we explore if there was an association between plasma NFL and different fatigue subtypes and whether baseline plasma NFL level can predict fatigue subtype conversion.

Background: Parkinson’s disease (PD) is a clinically heterogeneous disorder, characterized by a diverse array of motor and non-motor symptoms. Fatigue is a prevalent non-motor symptom occurring in the early stages of PD. Plasma neurofilament light chain (NFL) was elevated in PD patients and may be regarded as a biomarker for motor and cognitive progression.

Method: Patients with PD classified as persistent fatigue, never fatigue, non-persistent fatigue, and new-onset fatigue underwent detailed neurological evaluation at baseline and 2-year follow-up. Plasma NFL in PD patients and controls were measured using an ultrasensitive single molecule array.

Results: The study enrolled 177 PD patients and 95 control subjects. Plasma NFL levels were significantly higher in the persistent fatigue group compared to the never fatigue group at baseline and 2-year follow-up (P＜0.05). Longitudinally, 50.79% of baseline fatigue patients converted to non-fatigue at 2 years follow-up. Finally, 31.25% of without-figure patients converted to fatigue patients at 2 years follow-up. Baseline plasma NFL levels were significantly higher in non-fatigue patients converted to fatigue than non-converters in the baseline non-fatigue group (P＜0.05). Higher baseline plasma NFL levels were significantly associated with the non-fatigue subtype conversion (OR=1.423, P=0.020) after adjusting for confounders.

Conclusion: Baseline plasma NFL levels may be a biomarker for predicting fatigue subtype conversion and fatigue progression in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/plasma-nfl-predicting-fatigue-conversion-in-early-parkinsons-disease/