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Review
. 2023 Jun;130(6):755-762.
doi: 10.1007/s00702-023-02632-7. Epub 2023 Apr 17.

Blood neurofilament light chain in Parkinson's disease

Carsten Buhmann  1 , Tim Magnus  1   2 , Chi-Un Choe  3   4   5
Affiliations
Review

Blood neurofilament light chain in Parkinson's disease

Carsten Buhmann et al. J Neural Transm (Vienna). 2023 Jun.

Abstract

Blood neurofilament light chain (NfL) is an easily accessible, highly sensitive and reliable biomarker for neuroaxonal damage. Currently, its role in Parkinson's disease (PD) remains unclear. Here, we demonstrate that blood NfL can distinguish idiopathic PD from atypical parkinsonian syndromes (APS) with high sensitivity and specificity. In cross-sectional studies, some found significant correlations between blood NfL with motor and cognitive function, whereas others did not. In contrast, prospective studies reported very consistent associations between baseline blood NfL with motor progression and cognitive worsening. Amongst PD subtypes, especially postural instability and gait disorder (PIGD) subtype, symptoms and scores are reliably linked with blood NfL. Different non-motor PD comorbidities have also been associated with high blood NfL levels suggesting that the neuroaxonal damage of the autonomic nervous system as well as serotonergic, cholinergic and noradrenergic neurons is quantifiable. Numerous absolute NfL cutoff levels have been suggested in different cohort studies; however, validation across cohorts remains weak. However, age-adjusted percentiles and intra-individual blood NfL changes might represent more valid and consistent parameters compared with absolute NfL concentrations. In summary, blood NfL has the potential as biomarker in PD patients to be used in clinical practice for prediction of disease severity and especially progression.

Keywords: Biomarker; Blood; Hoehn and Yahr; MDS-UPDRS; MoCA.

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Conflict of interest statement

CB received a grant from the Hilde-Ulrichs-Stiftung, served on scientific advisory boards for Bial, Hormosan Pharma, Merz Pharmaceuticals and Zambon and received honoraria for lectures from Abbvie, Bial, Stada Pharma, TAD Pharma, UCB Pharma and Zambon. MU has nothing to declare. TM has nothing to declare. CUC reports personal fees from Desitin, Pfizer and Zambon outside the submitted work.

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