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Li W, Sun M, Chen C. Exploring the correlation between paediatric narcolepsy and serum neurofilament light chain levels: An exploratory study. Eur J Paediatr Neurol 2024; 52:82-85. [PMID: 39173568 DOI: 10.1016/j.ejpn.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 08/13/2024] [Accepted: 08/19/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND The study seeks to assess serum neurofilament light chain (NfL) levels in paediatric narcolepsy-diagnosed patients. Moreover, it aims to explore the correlation between NfL levels and the severity of narcolepsy symptoms, sleep quality, and manifestations of anxiety and depression. METHODS This retrospective analysis included 98 paediatric narcolepsy cases and 100 controls matched for age and gender. The study focused on comparing serum NfL levels across these groups. Severity of EDS in patients was measured with the Epworth Sleepiness Scale (ESS). Moreover, the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale-24 (HAMD-24), and Hamilton Anxiety Scale-14 (HAMA-14) were used to assess narcolepsy symptoms, sleep quality, and psychological conditions. RESULTS Patients with paediatric narcolepsy had significantly higher serum NfL levels than controls (P < 0.05). Additionally, a positive correlation was found between serum NfL levels and ESS scores (P < 0.001). An independent link between serum NfL and paediatric narcolepsy was established via multiple logistic regression (OR = 0.943, 95 % CI = 0.921-0.993, P = 0.004). Moreover, serum NfL's diagnostic precision for paediatric narcolepsy was evident from the ROC curve area of 0.938 (95 % CI: 0.86-0.99, P < 0.001). CONCLUSION The study implies a positive correlation between increased serum NfL levels and the severity of paediatric narcolepsy. Nevertheless, the causative link between serum NfL levels and paediatric narcolepsy remains uncertain, highlighting the need for larger sample sizes and well-structured cohort studies to offer more definitive.
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Affiliation(s)
- Weifeng Li
- Department of Neurology, Rongcheng People's Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Meijun Sun
- Department of Neurology, Rongcheng People's Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Chen Chen
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
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Xu Q, Wang J, Li H, Gao Y. Association between serum neurofilament light chains (sNfL) and neurologic disorders in a representative sample of US adults: a cross-sectional study. Rev Clin Esp 2024:S2254-8874(24)00092-4. [PMID: 38972635 DOI: 10.1016/j.rceng.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 06/18/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND While increased neurofilament light chain (NfL) in serum concentrations are linked to the progression of several neurological conditions, their distribution and implications within the general adult population remain largely unexplored. The current research aims to clarify the relationship between serum NfL levels and neurological disorders in a broad and representative population sample. METHODS We utilized information gathered from 1751 adults involved in the 2013-2014 cycle of the National Health and Nutrition Examination Survey . Our analytical approach encompassed logistic regression, smoothed curve fitting, and subgroup analyses to identify potential correlations between serum NfL levels and neurological conditions, such as depression, severe hearing and visual impairments, stroke, subjective memory deficits, and sleep problems. RESULTS After adjusting for all confounders, we found that higher serum NfL levels were significantly associated with increased risks of depression, stroke, subjective memory deficits, and longer sleep duration (p < 0.05). Subgroup analyses supported these findings. Additionally, BMI significantly influenced the relationship between serum NfL levels and long-term subjective memory decline. CONCLUSION Our research shows that higher serum NfL levels are strongly related to an elevated risk for several neurological disorders. These findings highlight the role of serum NfL serving as a critical marker for early detection and monitoring of neurological conditions, emphasizing its importance in both clinical and public health settings.
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Affiliation(s)
- Qi Xu
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Nanyang Medical College, Nanyang, China; Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China.
| | - Jiale Wang
- Department of Internal Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Hanzhi Li
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Nanyang Medical College, Nanyang, China
| | - Yuwan Gao
- Department of Ophthalmology, The First Affiliated Hospital of Nanyang Medical College, Nanyang, China
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3
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Beydoun MA, Noren Hooten N, Georgescu MF, Beydoun HA, Eid SM, Fanelli-Kuczmarski MT, Evans MK, Zonderman AB. Serum neurofilament light chain as a prognostic marker of all-cause mortality in a national sample of US adults. Eur J Epidemiol 2024; 39:795-809. [PMID: 38771439 PMCID: PMC11343803 DOI: 10.1007/s10654-024-01131-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/01/2024] [Indexed: 05/22/2024]
Abstract
Neurofilament light chain (NfL) is a neuron-specific structural protein released into the extracellular space, including body fluids, upon neuroaxonal damage. Despite evidence of a link in neurological disorders, few studies have examined the association of serum NfL with mortality in population-based studies. Data from the National Health and Nutrition Survey were utilized including 2,071 Non-Hispanic White, Non-Hispanic Black and Hispanic adult participants and adult participants of other ethnic groups (20-85 years) with serum NfL measurements who were followed for ≤ 6 years till 2019. We tested the association of serum NfL with mortality in the overall population and stratified by sex with the addition of potential interactive and mediating effects of cardio-metabolic risk factors and nutritional biomarkers. Elevated serum NfL levels (above median group) were associated with mortality risk compared to the below median NfL group in the overall sample (P = 0.010), with trends observed within each sex group (P < 0.10). When examining Loge NfL as a continuum, one standard deviation of Loge NfL was associated with an increased mortality risk (HR = 1.88, 95% CI 1.60-2.20, P < 0.001) in the reduced model adjusted for age, sex, race, and poverty income ratio; a finding only slightly attenuated with the adjustment of lifestyle and health-related factors. Four-way decomposition indicated that there was, among others, mediated interaction between NfL and HbA1c and a pure inconsistent mediation with 25(OH)D3 in predicting all-cause mortality, in models adjusted for all other covariates. Furthermore, urinary albumin-to-creatinine ratio interacted synergistically with NfL in relation to mortality risk both on the additive and multiplicative scales. These data indicate that elevated serum NfL levels were associated with all-cause mortality in a nationally representative sample of US adults.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA.
- NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview Blvd., Suite 100, Room #: 04B118, Baltimore, MD, 21224, USA.
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Michael F Georgescu
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Shaker M Eid
- Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
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4
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Wurm R, Prausmüller S, Ponleitner M, Spinka G, Weidenhammer A, Arfsten H, Heitzinger G, Panagiotides NG, Strunk G, Bartko P, Goliasch G, Stögmann E, Hengstenberg C, Hülsmann M, Pavo N. Serum Markers of Neurodegeneration Are Strongly Linked to Heart Failure Severity and Outcome. JACC. HEART FAILURE 2024; 12:1073-1085. [PMID: 38839151 DOI: 10.1016/j.jchf.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Cognitive impairment is prevalent in patients with heart failure with reduced ejection fraction (HFrEF), affecting self-care and outcomes. Novel blood-based biomarkers have emerged as potential diagnostic tools for neurodegeneration. OBJECTIVES This study aimed to assess neurodegeneration in HFrEF by measuring neurofilament light chain (NfL), total tau (t-tau), amyloid beta 40 (Aβ40), and amyloid beta 42 (Aβ42) in a large, well-characterized cohort. METHODS The study included 470 patients with HFrEF from a biobank-linked prospective registry at the Medical University of Vienna. High-sensitivity single-molecule assays were used for measurement. Unplanned heart failure (HF) hospitalization and all-cause death were recorded as outcome parameters. RESULTS All markers, but not the Aβ42:Aβ40 ratio, correlated with HF severity, ie, N-terminal pro-B-type natriuretic peptide and NYHA functional class, and comorbidity burden and were significantly associated with all-cause death and HF hospitalization (crude HR: all-cause death: NfL: 4.44 [95% CI: 3.02-6.53], t-tau: 5.04 [95% CI: 2.97-8.58], Aβ40: 3.90 [95% CI: 2.27-6.72], and Aβ42: 5.14 [95% CI: 2.84-9.32]; HF hospitalization: NfL: 2.48 [95% CI: 1.60-3.85], t-tau: 3.44 [95% CI: 1.95-6.04], Aβ40: 3.13 [95% CI: 1.84-5.34], and Aβ42: 3.48 [95% CI: 1.93-6.27]; P < 0.001 for all). These associations remained statistically significant after multivariate adjustment including N-terminal pro-B-type natriuretic peptide. The discriminatory accuracy of NfL in predicting all-cause mortality was comparable to the well-established risk marker N-terminal pro-B-type natriuretic peptide (C-index: 0.70 vs 0.72; P = 0.225), whereas the C-indices of t-tau, Aβ40, Aβ42, and the Aβ42:Aβ40 ratio were significantly lower (P < 0.05 for all). CONCLUSIONS Neurodegeneration is directly interwoven with the progression of HF. Biomarkers of neurodegeneration, particularly NfL, may help identify patients potentially profiting from a comprehensive neurological work-up. Further research is necessary to test whether early diagnosis or optimized HFrEF treatment can preserve cognitive function.
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Affiliation(s)
- Raphael Wurm
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Suriya Prausmüller
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Markus Ponleitner
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Georg Spinka
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Annika Weidenhammer
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Henrike Arfsten
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Gregor Heitzinger
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Noel Gilian Panagiotides
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | | | - Philipp Bartko
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Georg Goliasch
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Stögmann
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Christian Hengstenberg
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Martin Hülsmann
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
| | - Noemi Pavo
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
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Momkus J, Aiello AE, Stebbins R, Zhang Y, Harris KM. Sociodemographic patterns in biomarkers of aging in the Add Health cohort. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2024; 69:57-74. [PMID: 38551453 PMCID: PMC11209792 DOI: 10.1080/19485565.2024.2334687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Biomarkers in population health research serve as indicators of incremental physiological deterioration and contribute to our understanding of mechanisms through which social disparities in health unfold over time. Yet, few population-based studies incorporate biomarkers of aging in early midlife, when disease risks may emerge and progress across the life course. We describe the distributions of several biomarkers of inflammation and neurodegeneration and their variation by sociodemographic characteristics using blood samples collected during Wave V of the National Longitudinal Study of Adolescent to Adult Health (ages 33-44 years). Higher mean levels of inflammatory and neurodegenerative biomarkers were associated with greater socioeconomic disadvantage. For example, the neurodegenerative markers, Neurofilament Light Chain and total Tau proteins were higher among lower income groups, though the relationship was not statistically significant. Similarly, proinflammatory marker Tumor Necrosis Factor-α (TNF-α) levels were higher among those with lower education. Significant differences in the mean levels of other proinflammatory markers were observed by race/ethnicity, sex, census region, BMI, and smoking status. These descriptive findings indicate that disparities in biomarkers associated with aging are already evident among young adults in their 30s and attention should focus on age-related disease risk earlier in the life course.
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Affiliation(s)
- Jennifer Momkus
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Allison E. Aiello
- Robert N. Butler Columbia Aging Center, Columbia University, New York City, USA
| | - Rebecca Stebbins
- Robert N. Butler Columbia Aging Center, Columbia University, New York City, USA
| | - Yuan Zhang
- Robert N. Butler Columbia Aging Center, Columbia University, New York City, USA
| | - Kathleen Mullan Harris
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
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van Arendonk J, Wolters FJ, Neitzel J, Vinke EJ, Vernooij MW, Ghanbari M, Ikram MA. Plasma neurofilament light chain in relation to 10-year change in cognition and neuroimaging markers: a population-based study. GeroScience 2024; 46:57-70. [PMID: 37535203 PMCID: PMC10828339 DOI: 10.1007/s11357-023-00876-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/10/2023] [Indexed: 08/04/2023] Open
Abstract
Neurofilament light chain (NfL) is a promising biomarker for risk stratification and disease monitoring of dementia, but its utility in the preclinical disease stage remains uncertain. We determined the association of plasma NfL with (change in) neuroimaging markers and cognition in the population-based Rotterdam Study, using linear and logistic regression and mixed-effects models. Plasma NfL levels were measured using the Simoa NF-light™ assay in 4705 dementia-free participants (mean age 71.9 years, 57% women), who underwent cognitive assessment and brain MRI with repeated assessments over a 10-year follow-up period. Higher plasma NfL was associated with worse cognitive performance at baseline (g-factor: β = - 0.12 (- 0.15; - 0.09), p < 0.001), and accelerated cognitive decline during follow-up on the Stroop color naming task (β = 0.04 (0.02; 0.06), p < 0.001), with a smaller trend for decline in global cognition (g-factor β = - 0.02 (- 0.04; 0.00), p = 0.044). In the subset of 975 participants with brain MRI, higher NfL was associated with poorer baseline white matter integrity (e.g., global mean diffusivity: β = 0.12 (0.06; 0.19), p < 0.001), with similar trends for volume of white matter hyperintensities (β = 0.09 (0.02; 0.16), p = 0.011) and presence of lacunes (OR = 1.55 (1.13; 2.14), p = 0.007). Plasma NfL was not associated with volumes or thickness of the total gray matter, hippocampus, or Alzheimer signature regions. In conclusion, higher plasma NfL levels are associated with cognitive decline and larger burden of primarily white matter pathology in the general population.
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Affiliation(s)
- Joyce van Arendonk
- Department of Radiology and Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, the Netherlands
| | - Frank J Wolters
- Department of Radiology and Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, the Netherlands
| | - Julia Neitzel
- Department of Radiology and Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, the Netherlands
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - Elisabeth J Vinke
- Department of Radiology and Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, the Netherlands
| | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, the Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, the Netherlands.
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Garcia-Escobar G, Manero RM, Fernández-Lebrero A, Ois A, Navalpotro-Gómez I, Puente-Periz V, Contador-Muñana J, Estragués-Gazquez I, Puig-Pijoan A, Jiménez-Balado J. Blood Biomarkers of Alzheimer's Disease and Cognition: A Literature Review. Biomolecules 2024; 14:93. [PMID: 38254693 PMCID: PMC10813472 DOI: 10.3390/biom14010093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Recent advances in blood-based biomarkers of Alzheimer's Disease (AD) show great promise for clinical applications, offering a less invasive alternative to current cerebrospinal fluid (CSF) measures. However, the relationships between these biomarkers and specific cognitive functions, as well as their utility in predicting longitudinal cognitive decline, are not yet fully understood. This descriptive review surveys the literature from 2018 to 2023, focusing on the associations of amyloid-β (Aβ), Total Tau (t-Tau), Phosphorylated Tau (p-Tau), Neurofilament Light (NfL), and Glial Fibrillary Acidic Protein (GFAP) with cognitive measures. The reviewed studies are heterogeneous, varying in design and population (cognitively unimpaired, cognitively impaired, or mixed populations), and show results that are sometimes conflicting. Generally, cognition positively correlates with Aβ levels, especially when evaluated through the Aβ42/Aβ40 ratio. In contrast, t-Tau, p-Tau, Nfl, and GFAP levels typically show a negative correlation with cognitive performance. While p-Tau measures generally exhibit stronger associations with cognitive functions compared to other biomarkers, no single blood marker has emerged as being predominantly linked to a specific cognitive domain. These findings contribute to our understanding of the complex relationship between blood biomarkers and cognitive performance and underscore their potential utility in clinical assessments of cognition.
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Affiliation(s)
- Greta Garcia-Escobar
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
| | - Rosa Maria Manero
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Aida Fernández-Lebrero
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
| | - Angel Ois
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
| | - Irene Navalpotro-Gómez
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
| | - Victor Puente-Periz
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - José Contador-Muñana
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Isabel Estragués-Gazquez
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Albert Puig-Pijoan
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Joan Jiménez-Balado
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
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8
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Chen X, Lin Y, Wei K. Elevated Serum Neurofilament Light Chain Levels Are Associated With All-Cause Mortality: Evidence From National Health and Nutrition Examination Survey. J Gerontol A Biol Sci Med Sci 2023; 78:2382-2386. [PMID: 36811342 DOI: 10.1093/gerona/glad058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Several studies have reported the association between blood neurofilament light chain (NfL) levels and all-cause mortality. However, the generalizability of these findings in general adults remains unclear. The study aimed to examine the association between serum NfL and all-cause mortality in a nationally representative population. METHODS Longitudinal data were obtained from 2 071 participants aged 20-75 years in the National Health and Nutrition Examination Survey 2013-14 cycle. Serum NfL levels were measured by using a novel, high-throughput acridinium-ester immunoassay. Kaplan-Meier curves, multivariate Cox regression analysis, and restricted cubic spline regression were employed to investigate the association between serum NfL and all-cause mortality. RESULTS Over a median follow-up of 73 (interquartile range = 12) months, 85 (3.50%) participants died. After adjustment for sociodemographic characteristics, lifestyle variables, comorbidity, body mass index, and estimated glomerular filtration rate, elevated serum NfL levels were still significantly associated with a higher risk of all-cause mortality (hazard ratio = 2.45, 95% confidence interval = 1.89-3.18 for per lnNfL increase) in a linear manner. CONCLUSIONS Our findings suggest that circulating levels of NfL may serve as a biomarker of mortality risk in a nationally representative population.
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Affiliation(s)
- Xiaotong Chen
- Department of Laboratory Medicine, Jing'an District Central Hospital of Shanghai, Jing'an Branch Affiliated to Huashan Hospital, Fudan University, Shanghai, China
| | - Yong Lin
- Department of Laboratory Medicine, Jing'an District Central Hospital of Shanghai, Jing'an Branch Affiliated to Huashan Hospital, Fudan University, Shanghai, China
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Kai Wei
- Department of Pharmacy, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
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9
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Barba L, Vollmuth C, Abu-Rumeileh S, Halbgebauer S, Oeckl P, Steinacker P, Kollikowski AM, Schultz C, Wolf J, Pham M, Schuhmann MK, Heuschmann PU, Haeusler KG, Stoll G, Neugebauer H, Otto M. Serum β-synuclein, neurofilament light chain and glial fibrillary acidic protein as prognostic biomarkers in moderate-to-severe acute ischemic stroke. Sci Rep 2023; 13:20941. [PMID: 38017278 PMCID: PMC10684607 DOI: 10.1038/s41598-023-47765-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/17/2023] [Indexed: 11/30/2023] Open
Abstract
We aimed to assess the prognostic value of serum β-synuclein (β-syn), neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in patients with moderate-to-severe acute ischemic stroke. We measured β-syn, GFAP and NfL in serum samples collected one day after admission in 30 adult patients with moderate-to-severe ischemic stroke due to middle cerebral artery (MCA) occlusion. We tested the associations between biomarker levels and clinical and radiological scores (National Institute of Health Stroke Scale scores, NIHSS, and Alberta Stroke Program Early CT Score, ASPECTS), as well as measures of functional outcome (modified Rankin Scale, mRS). Serum biomarkers were significantly associated with ASPECTS values (β-syn p = 0.0011, GFAP p = 0.0002) but not with NIHSS scores at admission. Patients who received mechanical thrombectomy and intravenous thrombolysis showed lower β-syn (p = 0.029) und NfL concentrations (p = 0.0024) compared to patients who received only mechanical thrombectomy. According to median biomarker levels, patients with high β-syn, NfL or GFAP levels showed, after therapy, lower clinical improvement (i.e., lower 24-h NIHSS change), higher NIHSS scores during hospitalization and higher mRS scores at 3-month follow-up. Elevated serum concentrations of β-syn (p = 0.016), NfL (p = 0.020) or GFAP (p = 0.010) were significantly associated with 3-month mRS of 3-6 vs. 0-2 even after accounting for age, sex and renal function. In patients with moderate-to-severe acute ischemic stroke, serum β-syn, NfL and GFAP levels associated with clinical and radiological scores at different timepoints and were able to predict short- and middle-term clinical outcomes.
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Affiliation(s)
- Lorenzo Barba
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany
| | | | - Samir Abu-Rumeileh
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany
| | | | - Patrick Oeckl
- Department of Neurology, University of Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE E.V.), Ulm, Germany
| | - Petra Steinacker
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany
| | | | - Cara Schultz
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Judith Wolf
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Mirko Pham
- Department of Neuroradiology, University of Würzburg, Würzburg, Germany
| | | | - Peter U Heuschmann
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | | | - Guido Stoll
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | | | - Markus Otto
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany.
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10
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Huang Z, Haile K, Gedefaw L, Lau BWM, Jin L, Yip SP, Huang CL. Blood Biomarkers as Prognostic Indicators for Neurological Injury in COVID-19 Patients: A Systematic Review and Meta-Analysis. Int J Mol Sci 2023; 24:15738. [PMID: 37958721 PMCID: PMC10649265 DOI: 10.3390/ijms242115738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has been linked to various neurological complications. This meta-analysis assessed the relationship between glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) levels in the blood and neurological injury in COVID-19 patients. A comprehensive search of various databases was conducted until 18 August 2023, to find studies reporting GFAP and NfL blood levels in COVID-19 patients with neurological complications. GFAP and NfL levels were estimated between COVID-19 patients and healthy controls, and meta-analyses were performed using RevMan 5.4 software for analysis. In the 21 collected studies, it was found that COVID-19 patients had significantly higher levels of pooled GFAP (SMD = 0.52; 95% CI: 0.31, 0.73; p ≤ 0.001) and NfL (SMD = 0.60; 95% CI: 0.37, 0.82; p ≤ 0.001) when compared to the healthy controls. The pooled GFAP (SMD = 0.86; 95% CI: 0.26, 1.45; p ≤ 0.01) and NfL (SMD = 0.87; 95% CI: 0.48, 1.26; p ≤ 0.001) were significantly higher in non-survivors. These findings indicate a significant association between COVID-19 severity and elevated levels of GFAP and NfL, suggesting that GFAP and NfL could serve as potential diagnostic and prognostic markers for the early detection and monitoring of COVID-19-related neurological injuries.
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Affiliation(s)
- Zhiwei Huang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China; (Z.H.); (L.G.); (L.J.)
| | - Kassahun Haile
- Department of Medical Laboratory Science, Wolkite University, Wolkite P.O. Box 07, Ethiopia;
| | - Lealem Gedefaw
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China; (Z.H.); (L.G.); (L.J.)
| | - Benson Wui-Man Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Ling Jin
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China; (Z.H.); (L.G.); (L.J.)
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shea Ping Yip
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China; (Z.H.); (L.G.); (L.J.)
| | - Chien-Ling Huang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China; (Z.H.); (L.G.); (L.J.)
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11
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Beydoun MA, Noren Hooten N, Beydoun HA, Weiss J, Maldonado AI, Katzel LI, Davatzikos C, Gullapalli RP, Seliger SL, Erus G, Evans MK, Zonderman AB, Waldstein SR. Plasma neurofilament light and brain volumetric outcomes among middle-aged urban adults. Neurobiol Aging 2023; 129:28-40. [PMID: 37257406 PMCID: PMC10524231 DOI: 10.1016/j.neurobiolaging.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/05/2023] [Accepted: 04/30/2023] [Indexed: 06/02/2023]
Abstract
Elevated plasma neurofilament light chain (NfL) is associated with dementia though underlying mechanisms remain unknown. We examined cross-sectional relationships of time-dependent plasma NfL with selected brain structural magnetic resonance imaging (sMRI) prognostic markers of dementia. The sample was drawn from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study, selecting participants with complete v1 (2004-2009) and v2 (2009-2013) plasma NfL exposure and ancillary sMRI data at vscan (2011-2015, n = 179, mean v1 to vscan time: 5.4 years). Multivariable-adjusted linear regression models were conducted, overall, by sex, and race, correcting for multiple testing with q-values. NfL(v1) was associated with larger WMLV (both Loge transformed), after 5-6 years' follow-up, overall (β = +2.131 ± 0.660, b = +0.29, p = 0.001, and q = 0.0029) and among females. NfLv2 was linked to a 125 mm3 lower left hippocampal volume (p = 0.004 and q = 0.015) in reduced models, mainly among males, as was observed for annualized longitudinal change in NfL (δNfLbayes). Among African American adults, NfLv1 was inversely related to total, gray and white matter volumes. Plasma NfL may reflect future brain pathologies in middle-aged adults.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA.
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Jordan Weiss
- Department of Demography, University of California Berkeley, Berkeley, CA, USA
| | - Ana I Maldonado
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA; Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, USA
| | - Leslie I Katzel
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, USA; Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rao P Gullapalli
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Stephen L Seliger
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Guray Erus
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Shari R Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, USA; Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, USA; Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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12
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Ciardullo S, Muraca E, Bianconi E, Ronchetti C, Cannistraci R, Rossi L, Perra S, Zerbini F, Perseghin G. Serum neurofilament light chain levels are associated with all-cause mortality in the general US population. J Neurol 2023:10.1007/s00415-023-11739-6. [PMID: 37085649 DOI: 10.1007/s00415-023-11739-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Serum neurofilament light chain (sNfL) levels are biomarkers of neuro-axonal injury in multiple neurological diseases. Little is known on their potential role as prognostic markers in people without known neurological conditions. OBJECTIVE The aim of this study is to evaluate the association between sNfL levels and all-cause mortality in a general population setting. METHODS sNfL levels were measured in 2071 people aged 25-75 years from the general US population that participated in the 2013-2014 cycles of the National Health and Nutrition Examination Survey (NHANES). Cognitive function was evaluated in a subset of participants aged 60-75 years using the Consortium to Establish a Registry for Alzheimer's Disease-Word Learning test, the Animal Fluency test and the Digit Symbol Substitution test. We applied Cox proportional hazard models adjusted for several potential confounders to evaluate the association between sNfL and all-cause mortality through December 2019 by linking NHANES data with data from the National Death Index. RESULTS In a cross-sectional analysis, higher sNfL levels were associated with worse performance in all three cognitive function tests. Over a median follow-up of 6.1 years, 85 participants died. In a multivariable model adjusted for age, sex, race-ethnicity, diabetes, chronic kidney disease, harmful alcohol consumption, cigarette smoke and prevalent cardiovascular disease, higher sNfL levels were significantly and positively associated with all-cause mortality (HR per unit increase in log-transformed sNfL: 2.46, 95% CI 1.77-3.43, p < 0.001). Results were robust when analyses were stratified according to age, sex, body mass index and kidney function. CONCLUSION We found a positive association between sNfL levels and mortality in the general US population. Further studies are needed to understand the biological mechanisms underlying this association.
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Affiliation(s)
- Stefano Ciardullo
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy.
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
| | - Emanuele Muraca
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy
| | - Eleonora Bianconi
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy
| | - Celeste Ronchetti
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Rosa Cannistraci
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Laura Rossi
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy
| | - Silvia Perra
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy
| | - Francesca Zerbini
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy
| | - Gianluca Perseghin
- Department of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, 20900, Monza, MB, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
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13
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Margraf NG, Dargvainiene J, Theel E, Leypoldt F, Lieb W, Franke A, Berger K, Kuhle J, Kuhlenbaeumer G. Neurofilament light (NfL) as biomarker in serum and CSF in status epilepticus. J Neurol 2023; 270:2128-2138. [PMID: 36624182 PMCID: PMC10025237 DOI: 10.1007/s00415-022-11547-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE We explored the potential of neurofilament light chain (NfL) in serum and cerebrospinal fluid as a biomarker for neurodestruction in status epilepticus. METHODS In a retrospective analysis, we measured NfL in serum and cerebrospinal fluid samples of patients with status epilepticus using a highly sensitive single-molecule array technique (Simoa). Status epilepticus was diagnosed according to ILAE criteria. Additionally, we employed an alternative classification with more emphasis on the course of status epilepticus. We used data from three large control groups to compare NfL in status epilepticus versus neurologically healthy controls. RESULTS We included 28 patients (mean age: 69.4 years, SD: 15 years) with a median status duration of 44 h (IQR: 80 h). Twenty-one patients (75%) suffered from convulsive status epilepticus and seven (25%) from non-convulsive status epilepticus. Six patients died (21%). Cerebrospinal fluid and serum NfL concentrations showed a high correlation (r = 0.73, p < 0.001, Pearson). The main determinant of NfL concentration was the status duration. NfL concentrations did not differ between convulsive status epilepticus and convulsive status epilepticus classified according to the ILAE or to the alternative classification without and with adjusting for status duration and time between status onset and sampling. We found no association of NfL concentration with death, treatment refractoriness, or prognostic scores. CONCLUSION The results suggest that neurodestruction in status epilepticus measured by NfL is mainly determined by status duration, not status type nor therapy refractoriness. Therefore, our results suggest that regarding neurodestruction convulsive and non-convulsive status epilepticus are both neurological emergencies of comparable urgency.
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Affiliation(s)
- Nils G Margraf
- Department of Neurology, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts-University (CAU), Arnold-Heller-Str. 3, 24105, Kiel, Germany.
| | - Justina Dargvainiene
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts-University (CAU), Kiel, Germany
| | - Emily Theel
- Department of Neurology, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts-University (CAU), Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Frank Leypoldt
- Department of Neurology, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts-University (CAU), Arnold-Heller-Str. 3, 24105, Kiel, Germany
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts-University (CAU), Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology and Biobank PopGen, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts-University (CAU), Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jens Kuhle
- Multiple Sclerosis Centre, Neurology, Departments of Head, Spine and Neuromedicine, Biomedicine and Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), University Hospital and University of Basel, Basel, Switzerland
| | - Gregor Kuhlenbaeumer
- Department of Neurology, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts-University (CAU), Arnold-Heller-Str. 3, 24105, Kiel, Germany
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14
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Abu-Rumeileh S, Abdelhak A, Foschi M, D'Anna L, Russo M, Steinacker P, Kuhle J, Tumani H, Blennow K, Otto M. The multifaceted role of neurofilament light chain protein in non-primary neurological diseases. Brain 2023; 146:421-437. [PMID: 36083979 PMCID: PMC9494370 DOI: 10.1093/brain/awac328] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
The advancing validation and exploitation of CSF and blood neurofilament light chain protein as a biomarker of neuroaxonal damage has deeply changed the current diagnostic and prognostic approach to neurological diseases. Further, recent studies have provided evidence of potential new applications of this biomarker also in non-primary neurological diseases. In the present review we summarize the state of the art, future perspectives, but also limitations, of neurofilament light chain protein as a CSF and blood biomarker in several medical fields, including intensive care medicine, surgery, internal medicine and psychiatry. In particular, neurofilament light chain protein is associated with the degree of neurological impairment and outcome in patients admitted to intensive care units or in the perioperative phase and it seems to be highly interconnected with cardiovascular risk factors. Beyond that, interesting diagnostic and prognostic insights have been provided by the investigation of neurofilament light chain protein in psychiatric disorders as well as in the current coronavirus disease-19 pandemic and in normal ageing. Altogether, current data outline a multifaceted applicability of CSF and blood neurofilament light chain protein ranging from the critical clinical setting to the development of precision medicine models suggesting a strict interplay between the nervous system pathophysiology and the health-illness continuum.
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Affiliation(s)
- Samir Abu-Rumeileh
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
| | - Ahmed Abdelhak
- Department of Neurology, University of California San Francisco (UCSF), San Francisco, USA
- Department of Neurology, Ulm University Hospital, Ulm, Germany
| | - Matteo Foschi
- Department of Neuroscience, Neurology Unit – S. Maria delle Croci Hospital of Ravenna, AUSL Romagna, Ravenna, Italy
| | - Lucio D'Anna
- Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College London, NHS Healthcare Trust, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Michele Russo
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Petra Steinacker
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Markus Otto
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
- Department of Neurology, Ulm University Hospital, Ulm, Germany
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15
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Beydoun MA, Noren Hooten N, Weiss J, Maldonado AI, Beydoun HA, Katzel LI, Davatzikos C, Gullapalli RP, Seliger SL, Erus G, Evans MK, Zonderman AB, Waldstein SR. Plasma neurofilament light as blood marker for poor brain white matter integrity among middle-aged urban adults. Neurobiol Aging 2023; 121:52-63. [PMID: 36371816 PMCID: PMC9733693 DOI: 10.1016/j.neurobiolaging.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
Plasma neurofilament light chain (NfL)'s link to dementia may be mediated through white matter integrity (WMI). In this study, we examined plasma NfL's relationships with diffusion tensor magnetic resonance imaging markers: global and cortical white matter fractional anisotropy (FA) and trace (TR). Plasma NfL measurements at 2 times (v1: 2004-2009 and v2: 2009-2013) and ancillary dMRI (vscan: 2011-2015) were considered (n = 163, mean time v1 to vscan = 5.4 years and v2 to vscan: 1.1 years). Multivariable-adjusted regression models, correcting for multiple-testing revealed that, overall, higher NfLv1 was associated with greater global TR (β ± SE: +0.0000560 ± 0.0000186, b = 0.27, p = 0.003, q = 0.012), left frontal WM TR (β ± SE: + 0.0000706 ± 0.0000201, b ± 0.30, p = 0.001, q = 0.0093) and right frontal WM TR (β ± SE: + 0.0000767 ± 0.000021, b ± 0.31, p < 0.001, q = 0.0093). These associations were mainly among males and White adults. Among African American adults only, NfLv2 was associated with greater left temporal lobe TR. "Tracking high" in NfL was associated with reduced left frontal FA (Model 2, body mass index-adjusted: β ± SE:-0.01084 ± 0.00408, p = 0.009). Plasma NfL is a promising biomarker predicting future brain white matter integrity (WMI) in middle-aged adults.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Jordan Weiss
- Stanford Center on Longevity, Stanford University, Stanford, CA USA
| | - Ana I Maldonado
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA; Department of Psychology, University of Maryland, Catonsville, MD, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Leslie I Katzel
- Division of Gerontology, Geriatrics, and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rao P Gullapalli
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Stephen L Seliger
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Guray Erus
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Shari R Waldstein
- Department of Psychology, University of Maryland, Catonsville, MD, USA; Division of Gerontology, Geriatrics, and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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16
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Dong Y, Hou T, Li Y, Liu R, Cong L, Liu K, Liu C, Han X, Ren Y, Tang S, Winblad B, Blennow K, Wang Y, Du Y, Qiu C. Plasma Amyloid-β, Total Tau, and Neurofilament Light Chain Across the Alzheimer's Disease Clinical Spectrum: A Population-Based Study. J Alzheimers Dis 2023; 96:845-858. [PMID: 37899059 PMCID: PMC10657676 DOI: 10.3233/jad-230932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Plasma biomarkers have emerged as a promising approach for characterizing pathophysiology in mild cognitive impairment (MCI) and Alzheimer's disease (AD). OBJECTIVE We aimed to characterize plasma biomarkers for AD and neurodegeneration across the AD clinical continuum, and to assess their ability to differentiate between AD, MCI, and normal cognition. METHODS This population-based study engaged 1,446 rural-dwelling older adults (age ≥60 years, 61.0% women) derived from MIND-China; of these, 402 were defined with MCI and 142 with AD. Plasma amyloid-β (Aβ), total tau (t-tau), and neurofilament light chain (NfL) concentrations were analyzed using the Simoa platform. Data were analyzed using linear and logistic regression models, and receiver operating characteristic (ROC) analysis. RESULTS Across the AD clinical spectrum, plasma Aβ40 and NfL increased, whereas Aβ42/Aβ40 ratio decreased. Plasma t-tau was higher in people with AD dementia than those with MCI or normal cognition. Plasma NfL outperformed other biomarkers in differentiating AD from normal cognition (area under the ROC curve [AUC] = 0.75), but all plasma biomarkers performed poorly to distinguish MCI from normal cognition (AUC <0.60). Plasma NfL in combination with age, sex, education, and APOE genotype yielded the AUC of 0.87 for differentiating between AD and normal cognition, 0.79 between AD and MCI, and 0.64 between MCI and normal cognition. CONCLUSIONS In this Chinese population, AD plasma biomarkers vary by age, sex, and APOE genotype. Plasma Aβ, t-tau, and NfL differ across the AD clinical spectrum, and plasma NfL appears to be superior to plasma Aβ and t-tau for defining the clinical spectrum.
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Affiliation(s)
- Yi Dong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Institute of Brain Science and Brain-inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Yuanjing Li
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Rui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Keke Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Cuicui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Yifei Ren
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Bengt Winblad
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Institute of Brain Science and Brain-inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Institute of Brain Science and Brain-inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People’s Republic of China, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Institute of Brain Science and Brain-inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Nguyen AD, Malmstrom TK, Aggarwal G, Miller DK, Vellas B, Morley JE. Serum neurofilament light levels are predictive of all-cause mortality in late middle-aged individuals. EBioMedicine 2022; 82:104146. [PMID: 35830835 PMCID: PMC9284367 DOI: 10.1016/j.ebiom.2022.104146] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Blood biomarkers can offer valuable and easily accessible indicators of normal biological processes, pathogenic conditions, and responses to therapeutic interventions. Recent studies found that levels of neurofilament light chain (NfL) in the blood are associated with mortality in three European cohorts of older adults (median ages 73, 93, and 100 years). Whether similar associations exist in younger adults and in other ethnic groups is currently not known. METHODS We utilized a cohort study that included 294 African Americans (baseline ages 49-65). Serum NfL levels were measured using a Meso Scale Discovery-based assay. Vital status was determined by matching through the National Death Index. FINDINGS Seventy-two participants (24.5%) died during the 14-15 years of follow up (2000-2014). Baseline serum NfL levels were significantly higher in the decedent group (86.1±65.7 pg/ml vs. 50.1±28.0 pg/ml, p < 0·001). In binomial logistic regression models adjusted for age, gender, education, baseline smoking status, BMI, and total comorbidities (0-11), serum NfL levels remained a strong predictor of all-cause mortality, and sensitivity analyses employing multiple additional covariates did not substantively change the relationship. Further, Kaplan-Meier curves based on serum NfL quartiles showed reduced survival in groups with higher serum NfL levels. INTERPRETATION This study found a positive association between serum NfL levels and mortality in late middle-aged and older individuals. While our findings support that serum NfL levels may be a useful biomarker for all-cause mortality, further studies are needed to understand the biological mechanisms underlying this association. FUNDING National Institute on Aging, Saint Louis University.
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Affiliation(s)
- Andrew D Nguyen
- Division of Geriatric Medicine, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA; Department of Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, MO, USA; Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, MO, USA.
| | - Theodore K Malmstrom
- Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, MO, USA; Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Geetika Aggarwal
- Division of Geriatric Medicine, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA; Department of Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, MO, USA; Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, MO, USA
| | | | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; UMR 1295 INSERM, University of Toulouse III, Toulouse, France
| | - John E Morley
- Division of Geriatric Medicine, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
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18
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Rübsamen N, Willemse EAJ, Leppert D, Wiendl H, Nauck M, Karch A, Kuhle J, Berger K. A Method to Combine Neurofilament Light Measurements From Blood Serum and Plasma in Clinical and Population-Based Studies. Front Neurol 2022; 13:894119. [PMID: 35775045 PMCID: PMC9237479 DOI: 10.3389/fneur.2022.894119] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionNeurofilament light (NfL) can be detected in blood of healthy individuals and at elevated levels in those with different neurological diseases. We investigated if the choice of biological matrix can affect results when using NfL as biomarker in epidemiological studies.MethodWe obtained paired serum and EDTA-plasma samples of 299 individuals aged 37–67 years (BiDirect study) and serum samples of 373 individuals aged 65–83 years (MEMO study). In BiDirect, Passing–Bablok analyses were performed to assess proportional and systematic differences between biological matrices. Associations between serum or EDTA-plasma NfL and renal function (serum creatinine, serum cystatin C, glomerular filtration rate, and kidney disease) were investigated using linear or logistic regression, respectively. All regression coefficients were estimated (1) per one ng/L increase and (2) per one standard deviation increase (standardization using z-scores). In MEMO, regression coefficients were estimated (1) per one ng/L increase of serum or calculated EDTA-plasma NfL and (2) per one standard deviation increase providing a comparison to the results from BiDirect.ResultsWe found proportional and systematic differences between paired NfL measurements in BiDirect, i.e., serum NfL [ng/L] = −0.33 [ng/L] + 1.11 × EDTA-plasma NfL [ng/L]. Linear regression coefficients for the associations between NfL and renal function did not vary between the different NfL measurements. In MEMO, one standard deviation increase in serum NfL was associated with greater changes in the outcomes than in BiDirect.ConclusionAlthough there are differences between serum and EDTA-plasma NfL, results can be used interchangeably if standardized values are used.
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Affiliation(s)
- Nicole Rübsamen
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
- *Correspondence: Nicole Rübsamen
| | - Eline A. J. Willemse
- Neurologic Clinic and Policlinic, Departments of Biomedicine and Clinical Research, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - David Leppert
- Neurologic Clinic and Policlinic, Departments of Biomedicine and Clinical Research, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Heinz Wiendl
- Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, Departments of Biomedicine and Clinical Research, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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19
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Beydoun MA, Noren Hooten N, Weiss J, Beydoun HA, Hossain S, Evans MK, Zonderman AB. Plasma neurofilament light and its association with all-cause mortality risk among urban middle-aged men and women. BMC Med 2022; 20:218. [PMID: 35692046 PMCID: PMC9190073 DOI: 10.1186/s12916-022-02425-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/31/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Neurofilament light chain (NfL) is released into the blood during neuronal damage. NfL is linked to mortality in neurological disorders, remaining unexplored in population studies. We investigated whether initial (v1) and annualized change (δ) in plasma NfL can predict all-cause mortality in middle-aged dementia-free urban adults. METHODS Longitudinal data were from 694 participants in the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (HANDLS, mean agev1: 47.8 years, 42% male, 55.8% African American). Plasma NfL was measured prospectively at three visits. Analyses included Cox proportional hazards models for all-cause mortality risk and 4-way decomposition testing for interaction and mediation. RESULTS Unlike men, women exhibited a direct association between δNfL (above vs. below median) and all-cause mortality risk in both the minimally (HR = 3.91, 95% CI 1.10-13.9, p = 0.036) and fully adjusted models (HR = 4.92, 95% CI 1.26-19.2, p = 0.022), and for δNfL (per unit increase) in the full model (HR = 1.65, 95% CI 1.04-2.61, p = 0.034). In both models, and among women, 1 standard deviation of NfLv1 was associated with an increased all-cause mortality risk (reduced model: HR = 2.01, 95% CI 1.24-3.25, p = 0.005; full model: HR = 1.75, 95% CI 1.02-2.98, p = 0.041). Only few interactions were detected for cardio-metabolic risk factors. Notably, NfLv1 was shown to be a better prognostic indicator at normal hsCRP values among women, while HbA1c and δNfL interacted synergistically to determine mortality risk, overall. CONCLUSIONS These findings indicate that plasma NfL levels at baseline and over time can predict all-cause mortality in women and interacts with hsCRP and HbA1c to predict that risk.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, 251 Bayview Blvd., Suite 100, Room #: 04B118, Baltimore, MD, 21224, USA.
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, 251 Bayview Blvd., Suite 100, Room #: 04B118, Baltimore, MD, 21224, USA
| | - Jordan Weiss
- Department of Demography, University of California, Berkeley, Berkeley, CA, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, 251 Bayview Blvd., Suite 100, Room #: 04B118, Baltimore, MD, 21224, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, 251 Bayview Blvd., Suite 100, Room #: 04B118, Baltimore, MD, 21224, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, 251 Bayview Blvd., Suite 100, Room #: 04B118, Baltimore, MD, 21224, USA
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20
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Pratt J, De Vito G, Segurado R, Pessanha L, Dolan J, Narici M, Boreham C. Plasma neurofilament light levels associate with muscle mass and strength in middle-aged and older adults: findings from GenoFit. J Cachexia Sarcopenia Muscle 2022; 13:1811-1820. [PMID: 35415973 PMCID: PMC9178157 DOI: 10.1002/jcsm.12979] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Efforts to enhance diagnostic measures for sarcopenia have led to an increased focus on the screening utility of blood-based biomarkers. In this regard, circulating neurofilament light chain (NfL) levels are a potent indicator of axonal damage and have been linked with several neurological disorders. However, despite the strong neurogenic contribution to skeletal muscle health, no studies have explored the relevance of NfL concentrations to sarcopenia. With that in mind, this study aimed to examine the association between plasma NfL concentration and sarcopenic domains. METHODS Three hundred adults aged between 50 and 83 years participated to this study (male participants, n = 150; mean age: 64.2 ± 8.7 years and female participants, n = 150; mean age: 63.9 ± 8.3 years). Body composition was assessed using dual-energy X-ray absorptiometry, and a skeletal muscle index (SMI) was calculated. Muscle strength was assessed with hand dynamometry. Sarcopenia was classified using the European Working Group on Sarcopenia in Older People criteria. Plasma NfL concentration was determined using a highly sensitive, enzyme-linked immunosorbent assay. RESULTS Neurofilament light chain levels were associated with grip strength and SMI (P = 0.005 and P = 0.045, respectively) and were significantly elevated in sarcopenic individuals, compared with non-sarcopenic participants (P < 0.001). Individuals with pre-sarcopenia (either low grip strength or low SMI) had significantly higher NfL levels, compared with healthy controls (P = 0.001 and P = 0.006, respectively). Male participants with either low grip strength or low SMI had significantly raised NfL levels (P = 0.006 and P = 0.002, respectively), while in female participants, NfL concentrations were significantly elevated only in those with low grip strength (P = 0.049). NfL concentration displayed acceptable diagnostic accuracy for sarcopenia (area under the curve = 0.726, P < 0.001). CONCLUSIONS Our study clearly demonstrates the indicative pertinence of circulating NfL levels to sarcopenic domains, supporting its potential use as a biomarker of sarcopenia. More studies are needed, however, to further illuminate the diagnostic value of circulating NfL. Future research should explore whether NfL levels are more powerfully linked with muscle strength than mass and whether sex mediates the relevance of NfL concentrations to sarcopenic phenotypes.
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Affiliation(s)
- Jedd Pratt
- Institute for Sport and Health, University College Dublin, Dublin, Ireland.,Genuity Science, Dublin, Ireland
| | - Giuseppe De Vito
- Department of Biomedical Sciences, CIR-Myo Myology Centre, Neuromuscular Physiology Laboratory, University of Padova, Padua, Italy
| | - Ricardo Segurado
- Centre for Support and Training in Analysis and Research, and School of Public Health, Physiotherapy and Sports Sciences, University College Dublin, Dublin, Ireland
| | - Ludmilla Pessanha
- Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | | | - Marco Narici
- Department of Biomedical Sciences, CIR-Myo Myology Centre, Neuromuscular Physiology Laboratory, University of Padova, Padua, Italy
| | - Colin Boreham
- Institute for Sport and Health, University College Dublin, Dublin, Ireland
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21
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Razia R, Majeed F, Amin R, Mukhtar S, Mehmood K, Baig DN. The analysis of dynamic gene expression patterns in peripheral blood of multiple sclerosis patients indicates possible diagnostic and prognostic biomarkers. Mol Immunol 2022; 147:147-156. [PMID: 35594733 DOI: 10.1016/j.molimm.2022.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/08/2022] [Accepted: 05/09/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Among numerous invasive procedures for the research of biomarkers, blood-based indicators are regarded as marginally non-invasive procedures in the diagnosis and prognosis of demyelinating disorders, including multiple sclerosis (MS). In this study, we looked into the blood-derived gene expression profiles of patients with multiple sclerosis to investigate their clinical traits and linked them with dysregulated gene expressions to establish diagnostic and prognostic indicators. METHODS We included 51 patients with relapsing-remitting MS (RRMS, n = 31), clinically isolated syndrome (CIS, n = 12), primary progressive MS (PPMS, n = 8) and a control group (n = 51). Using correlational analysis, the transcriptional patterns of chosen gene panels were examined and subsequently related with disease duration and the expanded disease disability score (EDSS). In addition, principal component analysis, univariate regression, and logistic regression analysis were employed to highlight distinct profiles of genes and prognosticate the excellent biomarkers of this illness. RESULTS Our findings demonstrated that neurofilament light (NEFL), tumor necrosis factor α (TNF-α), Tau, and clusterin (CLU) were revealed to be increased in recruited patients, whereas the presenilin-1 (PSEN1) and cell-surface glycoprotein-44 (CD44) were downregulated. Principal Component Analysis revealed distinct patterns between the MS and control groups. Correlation analysis indicated co-dependent dysregulated genes and their differential expression with clinical findings. Furthermore, logistic regression demonstrated that Clusterin (AUC=0.940), NEFL (AUC=0.775), TNF-α (AUC=0.817), Tau (AUC=0.749), PSEN1 (AUC=0.6913), and CD44 (AUC=0.832) had diagnostic relevance. Following the univariate linear regression, a significant regression equation was found between EDSS and IGF-1 (R2 adj = 0.10844; p= 0.0060), APP (R2 adj = 0.1107; p= 0.0098), and PSEN1 (R2 adj = 0.1266; p=0.0102). CONCLUSION This study exhibits dynamic gene expression patterns that represent the significance of specified genes that are prospective diagnostic and prognostic biomarkers for multiple sclerosis.
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Affiliation(s)
- Rabat Razia
- School of Life Sciences, Forman Christian College (A Chartered University), Lahore 54600, Pakistan.
| | | | - Rehab Amin
- School of Life Sciences, Forman Christian College (A Chartered University), Lahore 54600, Pakistan.
| | - Shahid Mukhtar
- Punjab Institute of Neurosciences, Ferozpur Road, Lahore 54000, Punjab
| | - Khalid Mehmood
- Punjab Institute of Neurosciences, Ferozpur Road, Lahore 54000, Punjab
| | - Deeba Noreen Baig
- School of Life Sciences, Forman Christian College (A Chartered University), Lahore 54600, Pakistan.
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22
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Fohner AE, Bartz TM, Tracy RP, Adams HHH, Bis JC, Djousse L, Satizabal CL, Lopez OL, Seshadri S, Mukamal KJ, Kuller LH, Psaty BM, Longstreth WT. Association of Serum Neurofilament Light Chain Concentration and MRI Findings in Older Adults: The Cardiovascular Health Study. Neurology 2022; 98:e903-e911. [PMID: 34921102 PMCID: PMC8901174 DOI: 10.1212/wnl.0000000000013229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/08/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Neurofilament light chain (NfL) in blood is a sensitive but nonspecific marker of brain injury. This study sought to evaluate associations between NfL concentration and MRI findings of vascular brain injury in older adults. METHODS A longitudinal cohort study included 2 cranial MRI scans performed about 5 years apart and assessed for white matter hyperintensities (WMH) and infarcts. About 1 year before their second MRI, 1,362 participants (median age 77 years, 61.4% women) without a history of TIA or stroke had measurement of 4 biomarkers: NfL, total tau, glial fibrillary acidic protein (GFAP), and ubiquitin carboxyl-terminal hydrolase L1. Most (n = 1,279) also had the first MRI scan, and some (n = 633) had quantitative measurements of hippocampal and WMH. In primary analyses, we assessed associations of NfL with a 10-point white matter grade (WMG) and prevalent infarcts on second MRI and with worsening WMG and incident infarct comparing the 2 scans. A p value <0.0125 (0.05/4) was considered significant for these analyses. We also assessed associations with hippocampal and WMH volume. RESULTS In fully adjusted models, log2(NfL) concentration was associated with WMG (β = 0.27; p = 2.3 × 10-4) and worsening WMG (relative risk [RR] 1.24; p = 0.0022), but less strongly with prevalent brain infarcts (RR 1.18; p = 0.013) and not with incident brain infarcts (RR 1.18; p = 0.18). Associations were also present with WMH volume (β = 2,242.9, p = 0.0036). For the other 3 biomarkers, the associations for log2 (GFAP) concentration with WMG and worsening WMG were significant. DISCUSSION Among older adults without a history of stroke, higher serum NfL concentration was associated with covert MRI findings of vascular brain injury, especially the burden of WMH and its worsening. Whether these results offer opportunities for the use of NfL as a noninvasive biomarker of WMH or to control vascular risk factors remains to be determined.
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Affiliation(s)
- Alison E Fohner
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA.
| | - Traci M Bartz
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Russell P Tracy
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Hieab H H Adams
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Joshua C Bis
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Luc Djousse
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Claudia L Satizabal
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Oscar L Lopez
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Sudha Seshadri
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Kenneth J Mukamal
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Lewis H Kuller
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - Bruce M Psaty
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
| | - W T Longstreth
- From the Department of Epidemiology (A.E.F., B.M.P., W.T.L.), Institute of Public Health Genetics (A.E.F.), Department of Biostatistics (T.M.B.), Cardiovascular Health Research Unit (J.C.B., B.M.P., A.E.F.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Department of Neurology (W.T.L.), University of Washington, Seattle; Departments of Pathology & Laboratory Medicine and Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington; Departments of Clinical Genetics and Radiology and Nuclear Medicine (H.H.H.A.), Erasmus University Medical Center, Rotterdam, the Netherlands; Division of Aging, Department of Medicine (L.D.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases and Department of Neurology (C.L.S., S.S.), University of Texas Health Science Center at San Antonio; Boston University School of Medicine (C.L.S., S.S.); Framingham Heart Study (C.L.S., S.S.), MA; Departments of Neurology and Psychiatry (O.L.L.) and Epidemiology (L.H.K.), University of Pittsburgh, PA; and Department of Medicine (K.J.M.), Beth Israel Deaconess Medical Center, Boston, MA
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23
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Redondo-Camós M, Cattaneo G, Perellón-Alfonso R, Alviarez-Schulze V, Morris TP, Solana-Sanchez J, España-Irla G, Delgado-Gallén S, Pachón-García C, Albu S, Zetterberg H, Tormos JM, Pascual-Leone A, Bartres-Faz D. Local Prefrontal Cortex TMS-Induced Reactivity Is Related to Working Memory and Reasoning in Middle-Aged Adults. Front Psychol 2022; 13:813444. [PMID: 35222201 PMCID: PMC8866698 DOI: 10.3389/fpsyg.2022.813444] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/18/2022] [Indexed: 12/19/2022] Open
Abstract
Introduction The prefrontal cortex (PFC) plays a crucial role in cognition, particularly in executive functions. Cortical reactivity measured with Transcranial Magnetic Stimulation combined with Electroencephalography (TMS-EEG) is altered in pathological conditions, and it may also be a marker of cognitive status in middle-aged adults. In this study, we investigated the associations between cognitive measures and TMS evoked EEG reactivity and explored whether the effects of this relationship were related to neurofilament light chain levels (NfL), a marker of neuroaxonal damage. Methods Fifty two healthy middle-aged adults (41–65 years) from the Barcelona Brain Health Initiative cohort underwent TMS-EEG, a comprehensive neuropsychological assessment, and a blood test for NfL levels. Global and Local Mean-Field Power (GMFP/LMFP), two measures of cortical reactivity, were quantified after left prefrontal cortex (L-PFC) stimulation, and cognition was set as the outcome of the regression analysis. The left inferior parietal lobe (L-IPL) was used as a control stimulation condition. Results Local reactivity was significantly associated with working memory and reasoning only after L-PFC stimulation. No associations were found between NfL and cognition. These specific associations were independent of the status of neuroaxonal damage indexed by the NfL biomarker and remained after adjusting for age, biological sex, and education. Conclusion Our results demonstrate that TMS evoked EEG reactivity at the L-PFC, but not the L-IPL, is related to the cognitive status of middle-aged individuals and independent of NfL levels, and may become a valuable biomarker of frontal lobe-associated cognitive function.
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Affiliation(s)
- María Redondo-Camós
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Ruben Perellón-Alfonso
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Departament de Medicina, Facultat de Medicina i Ciències de la Salut, i Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Vanessa Alviarez-Schulze
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain.,Departamento de Ciencias del Comportamiento, Escuela de Psicología, Universidad Metropolitana, Caracas, Venezuela
| | - Timothy P Morris
- Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA, United States
| | - Javier Solana-Sanchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Goretti España-Irla
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Selma Delgado-Gallén
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Catherine Pachón-García
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Sergiu Albu
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, University College London Institute of Neurology, London, United Kingdom.,UK Dementia Research Institute, University College London, London, United Kingdom.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Josep M Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States.,Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - David Bartres-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Departament de Medicina, Facultat de Medicina i Ciències de la Salut, i Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
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24
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Lu WH, Giudici KV, Guyonnet S, Aggarwal G, Nguyen AD, Morley JE, Vellas B, de Souto Barreto P. Associations of plasma neurofilament light chain and progranulin with frailty in older adults. J Am Geriatr Soc 2021; 70:1236-1243. [PMID: 34908159 DOI: 10.1111/jgs.17604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/16/2021] [Accepted: 11/21/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND In previous studies, plasma neurofilament light chain (NfL) and progranulin (PGRN) levels are associated with cognitive and physical impairment in older individuals. However, evidence of their relationships with frailty is lacking. This study aims to explore the associations of plasma NfL and PGRN levels with frailty in community-dwelling older adults. METHODS We included 507 older adults (mean [standard deviation] age, 76.7 [4.5] years) with plasma NfL and PGRN measurements from the Multidomain Alzheimer Preventive Trial (MAPT). The timepoint of biomarker measurements, either 12 or 24 months after study enrollment, was defined as the baseline for each participant. Frailty phenotype (robust, pre-frail, and frail) was assessed at 12, 24, 36, 48, and 60 months by Fried's frailty criteria. The cross-sectional associations between plasma neurodegenerative biomarkers and frailty severity were examined using logistic regressions. We further used Cox proportional hazard models to evaluate the associations between plasma biomarkers and incident frailty among robust or pre-frail participants at baseline (n = 403). RESULTS At baseline, participants with high plasma NfL levels (>93.11 pg/ml [the upper quartile]) had a higher likelihood of pre-frailty or frailty compared to their normal NfL counterparts (odds ratio = 1.68; 95% confidence interval = 1.10-2.57); however, this association did not remain significant after controlling for covariates. Neither NfL nor PGRN levels showed prospective associations with incident frailty over 4 years. CONCLUSIONS This study failed to find associations of circulating NfL and PGRN levels with frailty among community-dwelling older adults in adjusted analyses. Whether plasma neurodegenerative markers serve as potential biomarkers of frailty requires further investigation.
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Affiliation(s)
- Wan-Hsuan Lu
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France
| | - Kelly Virecoulon Giudici
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Sophie Guyonnet
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France
| | - Geetika Aggarwal
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA.,Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, Missouri, USA
| | - Andrew D Nguyen
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA.,Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, Missouri, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Bruno Vellas
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France
| | - Philipe de Souto Barreto
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France
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25
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Beydoun MA, Noren Hooten N, Beydoun HA, Maldonado AI, Weiss J, Evans MK, Zonderman AB. Plasma neurofilament light as a potential biomarker for cognitive decline in a longitudinal study of middle-aged urban adults. Transl Psychiatry 2021; 11:436. [PMID: 34420032 PMCID: PMC8380245 DOI: 10.1038/s41398-021-01563-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/28/2021] [Accepted: 08/12/2021] [Indexed: 12/13/2022] Open
Abstract
Plasma neurofilament light (NfL) is a marker for neurodegenerative diseases. Few studies have examined the association of NfL with middle-aged changes in cognitive performance, and no studies have examined differential NfL effects by race. Using data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n = 625, Agev1: 30-66 y, 41.6% male, 56.3% African American, 27.8% below poverty), we investigated the associations of initial NfL levels and annualized change with cognitive performance over time in global mental status, verbal and visual memory, fluency, attention, and executive function. We used ordinary least squares and mixed-effects regressions stratified by race, while exploring differential associations by age group, sex, and poverty status. Over a mean follow-up of 4.3 years, we found initial NfL level was associated with a faster decline on normalized mental status scores in Whites only and in those >50 years old. Annualized increase in NfL was associated with a greater decline in verbal fluency in men. In other exploratory analyses, annualized increase in NfL was associated with a slower decline in verbal memory among individuals living above poverty; in the older group (>50 years), first-visit NfL was linked with better performance at baseline in global mental status and verbal memory. In summary, first-visit NfL was primarily associated with the global mental status decline among Whites, while exhibiting inconsistent relationships in some exploratory analyses. Plasma NfL levels can be detected and quantified in non-demented middle-aged adults and changes can be analyzed over time. More longitudinal studies are needed to address the clinical utility of this biomarker for early cognitive defects.
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Affiliation(s)
- May A. Beydoun
- grid.419475.a0000 0000 9372 4913Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD USA
| | - Nicole Noren Hooten
- grid.419475.a0000 0000 9372 4913Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD USA
| | - Hind A. Beydoun
- grid.413661.70000 0004 0595 1323Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA USA
| | - Ana I. Maldonado
- grid.419475.a0000 0000 9372 4913Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD USA ,grid.266673.00000 0001 2177 1144Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD USA
| | - Jordan Weiss
- grid.47840.3f0000 0001 2181 7878Department of Demography, University of California, Berkeley, Berkeley, CA USA
| | - Michele K. Evans
- grid.419475.a0000 0000 9372 4913Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD USA
| | - Alan B. Zonderman
- grid.419475.a0000 0000 9372 4913Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD USA
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