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Review
. 2019 Aug;90(8):870-881.
doi: 10.1136/jnnp-2018-320106. Epub 2019 Apr 9.

Neurofilament light chain as a biomarker in neurological disorders

Lorenzo Gaetani  1 , Kaj Blennow  2   3 , Paolo Calabresi  4   5 , Massimiliano Di Filippo  4 , Lucilla Parnetti  4 , Henrik Zetterberg  2   3   6   7
Affiliations
Review

Neurofilament light chain as a biomarker in neurological disorders

Lorenzo Gaetani et al. J Neurol Neurosurg Psychiatry. 2019 Aug.

Abstract

In the management of neurological diseases, the identification and quantification of axonal damage could allow for the improvement of diagnostic accuracy and prognostic assessment. Neurofilament light chain (NfL) is a neuronal cytoplasmic protein highly expressed in large calibre myelinated axons. Its levels increase in cerebrospinal fluid (CSF) and blood proportionally to the degree of axonal damage in a variety of neurological disorders, including inflammatory, neurodegenerative, traumatic and cerebrovascular diseases. New immunoassays able to detect biomarkers at ultralow levels have allowed for the measurement of NfL in blood, thus making it possible to easily and repeatedly measure NfL for monitoring diseases' courses. Evidence that both CSF and blood NfL may serve as diagnostic, prognostic and monitoring biomarkers in neurological diseases is progressively increasing, and NfL is one of the most promising biomarkers to be used in clinical and research setting in the next future. Here we review the most important results on CSF and blood NfL and we discuss its potential applications and future directions.

Keywords: Parkinson's disease; dementia; motor neuron disease; multiple sclerosis; traumatic brain injury.

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Conflict of interest statement

Competing interests: LG received travel grants from Biogen-Idec, Biogen, Novartis, Teva, Genzyme and Almirall to attend national and international conferences. KB has served as a consultant or at advisory boards for Alzheon, BioArctic, Biogen, Eli Lilly, Fujirebio Europe, IBL International, Pfizer and Roche Diagnostics, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB, a GU Ventures-based platform company at the University of Gothenburg. PC receives research support from Bayer Schering, Biogen-Dompé, Boehringer Ingelheim, Eisai, Lundbeck, Merck-Serono, Novartis, Sanofi-Aventis, Sigma-Tau and UCB Pharma. MDF participated to advisory boards of Biogen Idec, Teva and Bayer, received travel grants from Bayer Schering, Biogen-Dompé, Biogen-Idec, Merck-Serono, Novartis and Sanofi-Aventis to attend national and international conferences, and received speaker and writing honoraria from Biogen Idec, Novartis and Sanofi-Genzyme. HZ has served at advisory boards for Eli Lilly, Roche Diagnostics and Pharmasum Therapeutics, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB, a GU Ventures-based platform company at the University of Gothenburg. LP reports no conflict of interest.

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