Significance of CSF NfL and tau in ALS

AbstractCerebrospinal fluid (CSF) neurofilament light chain (NfL) has emerged as putative diagnostic biomarker in amyotrophic lateral sclerosis (ALS), but it remains a matter of debate, whether CSF total tau (ttau), tau phosphorylated at threonine 181 (ptau) and the ptau/ttau ratio could serve as diagnostic biomarker in ALS as well. Moreover, the relationship between CSF NfL and tau measures to further axonal and (neuro)degeneration markers still needs to be elucidated. Our analysis included 89 ALS patients [median (range) age 63 (33 –83) years, 61% male, disease duration 10 (0.2–190) months] and 33 age- and sex-matched disease controls [60 (32–76), 49%]. NfL was higher and the ptau/ttau ratio was lower in ALS compared to controls [8343 (1795–35,945) pg/ml vs. 1193 (612–2616),H(1)  = 70.8,p <  0.001; mean (SD) 0.17 (0.04) vs. 0.2 (0.03),F(1)  = 14.3,p <  0.001], as well as in upper motor neuron dominant (UMND,n = 10) compared to classic (n = 46) or lower motor neuron dominant ALS [n = 31; for NfL: 16,076 (7447–35,945) vs. 8205 (2651–35,138) vs. 8057 (1795–34,951)],Z ≥ 2.5,p ≤ 0.01; for the ptau/ttau ratio: [0.13 (0.04) vs. 0.17 (0.04) vs. 0.18 (0.03),p ≤ 0.02]. In ALS, NfL and the ptau/ttau ratio were related to corticospinal tract (CST) fractional anisotropy (FA) and radial diffusivity (ROI-based approach and whole-brain voxelwise analysis). Factor analysis of mixed data revealed a co-variance pattern betwee...
Source: Journal of Neurology - Category: Neurology Source Type: research