Cerebrospinal fluid neurofilament light predicts longitudinal diagnostic change in patients with psychiatric and neurodegenerative disorders
Year: 2023
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: People with neuropsychiatric symptoms often experience delay in accurate diagnosis. Although cerebrospinal fluid neurofilament light (CSF NfL) shows promise in distinguishing neurodegenerative disorders (ND) from psychiatric disorders (PSY), its accuracy in a diagnostically challenging cohort longitudinally is unknown. METHODS: We collected longitudinal diagnostic information (mean = 36 months) from patients assessed at a neuropsychiatry service, categorising diagnoses as ND/mild cognitive impairment/other neurological disorders (ND/MCI/other) and PSY. We pre-specified NfL > 582 pg/mL as indicative of ND/MCI/other. RESULTS: Diagnostic category changed from initial to final diagnosis for 23% (49/212) of patients. NfL predicted the final diagnostic category for 92% (22/24) of these and predicted final diagnostic category overall (ND/MCI/other vs. PSY) in 88% (187/212), compared to 77% (163/212) with clinical assessment alone. CONCLUSIONS: CSF NfL improved diagnostic accuracy, with potential to have led to earlier, accurate diagnosis in a real-world setting using a pre-specified cut-off, adding weight to translation of NfL into clinical practice.
Source: Acta Neuropsychiatrica
DOI: 10.1017/neu.2023.25
Authors: Matthew J. Y. Kang, Dhamidhu Eratne, Hannah Dobson, Charles B. Malpas, Michael Keem, Courtney Lewis, Jasleen Grewal, Vivian Tsoukra, Christa Dang, Ramon Mocellin, Tomas Kalincik, Alexander F. Santillo, Henrik Zetterberg, Kaj Blennow, Christiane Stehmann, Shiji Varghese, Qiao-Xin Li, Colin L. Masters, Steven Collins, Samuel F. Berkovic, Andrew Evans, Wendy Kelso, Sarah Farrand, Samantha M. Loi, Mark Walterfang, Dennis Velakoulis
Institutions: The Royal Melbourne Hospital, The University of Melbourne, The Alfred Hospital, Alfred Health, Evangelismos Hospital, National Ageing Research Institute, Lund University, Skåne University Hospital, Sahlgrenska University Hospital, UK Dementia Research Institute, National Hospital for Neurology and Neurosurgery, UCL Queen Square Institute of Neurology, University College London, University of Gothenburg, Florey Institute of Neuroscience and Mental Health, Austin Health
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,255
Funders: Alzheimer's Association, Alzheimer's Drug Discovery Foundation, Pfizer, Teva Pharmaceutical Industries, Northwestern University, Familjen Erling-Perssons Stiftelse, Stiftelsen för Gamla Tjänarinnor, EU Joint Programme – Neurodegenerative Disease Research, Australian Government, European Commission, Monash University, University of Melbourne, Hjärnfonden, Vetenskapsrådet, Ipsen, UK Dementia Research Institute, Olav Thon Stiftelsen, Allergan, National Health and Medical Research Council, H2020 European Research Council
Awards: G1057200632, G1088883541, G1135383168, G1222782219, G1311708188, G1373393710, G150733400, G1551449788, G1588116593, G1802301745, G1833008592, Understanding Alzheimer Blood Biomarkers for Tau Pathology, G201353144, G2057385626, G237833635, G2385484910, G2543812357, The Alzheimer biomarker toolbox – use in pathogenic studies, diagnostics and theragnostics, G2841269746, G292763017, G3027168043, G308275008, G3126964432, G313301595, G3241251457, G3914690605, G4181470480, G4260843567, G432431387, G434337789, G4404751248, G5040492720, G5332654608, G5619554209, G56684467, G6142763750, G6168044258, G6289970089, Multi-omics Interdisciplinary Research Integration to Address DEmentia diagnosis, G691317373, Pathways to Alzheimer's disease, G712881263, G7143958211, MiND: Markers in Neuropsychiatric Disorders, G791739130, What determines amyloid beta aggregation and toxicity in Alzheimer’s disease?, G958583170
OpenAlex ID: W4367299284