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NfL as a biomarker for neurodegeneration and survival in Parkinson disease
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).ORCID iD: 0000-0001-5227-8117
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2020 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 95, no 7, p. e827-e838Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine whether neurofilament light chain protein in CSF (cNfL), a sensitive biomarker of neuroaxonal damage, reflects disease severity or can predict survival in Parkinson disease (PD).

METHODS: We investigated whether disease severity, phenotype, or survival in patients with new-onset PD correlates with cNfL concentrations around the time of diagnosis in the population-based New Parkinsonism in Umeå (NYPUM) study cohort (n = 99). A second, larger new-onset PD cohort (n = 194) was used for independent validation. Association of brain pathology with the cNfL concentration was examined with striatal dopamine transporter imaging and repeated diffusion tensor imaging at baseline and 1 and 3 years.

RESULTS: Higher cNfL in the early phase of PD was associated with greater severity of all cardinal motor symptoms except tremor in both cohorts and with shorter survival and impaired olfaction. cNfL concentrations above the median of 903 ng/L conferred an overall 5.8 times increased hazard of death during follow-up. After adjustment for age and sex, higher cNfL correlated with striatal dopamine transporter uptake deficits and lower fractional anisotropy in diffusion tensor imaging of several axonal tracts.

CONCLUSIONS: cNfL shows usefulness as a biomarker of disease severity and to predict survival in PD. The present results indicate that the cNfL concentration reflects the intensity of the neurodegenerative process, which could be important in future clinical trials.

CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with PD, cNfL concentrations are associated with more severe disease and shorter survival.

Place, publisher, year, edition, pages
Wolters Kluwer, 2020. Vol. 95, no 7, p. e827-e838
National Category
Neurology
Research subject
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-178856DOI: 10.1212/WNL.0000000000010084ISI: 000619277100005PubMedID: 32680941Scopus ID: 2-s2.0-85089787234OAI: oai:DiVA.org:umu-178856DiVA, id: diva2:1526989
Available from: 2021-02-09 Created: 2021-02-09 Last updated: 2023-09-05Bibliographically approved

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Bäckström, David CLinder, JanJakobson Mo, SusannaRiklund, KatrineLenfeldt, Niklas

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