E Thouvenot1, C Demattei2, S Lehmann3, A Maceski-Maleska3, C Hirtz3, R Juntas-Morales4, N Pageot4, F Esselin4, S Alphandéry4, T Vincent5, W Camu4. 1. Service de Neurologie, CHU Nîmes, CNRS, INSERM, Univ Montpellier, Nîmes, France. 2. Département d'Information Médicale, CHU Nîmes, Univ Montpellier, Nîmes, France. 3. Laboratoire de Biochimie et Plateforme de Protéomique Clinique, CHU Montpellier, INSERM, Univ Montpellier, Montpellier, France. 4. Centre de référence SLA, CHU Montpellier, INSERM, Univ Montpellier, Montpellier, France. 5. Laboratoire d'Immunologie, CHU Montpellier, INSERM, Univ Montpellier, Montpellier, France.
Abstract
BACKGROUND AND PURPOSE: The prognostic value of serum neurofilament light chain (sNfL), a biomarker of neurodegeneration, compared to other prognostic factors of amyotrophic lateral sclerosis (ALS) at the time of diagnosis, remains unclear. METHODS: Sera from ALS patients were prospectively collected at the first diagnostic visit in our centre. sNfL levels were determined by single molecule array in 207 ALS patients and in 21 healthy controls. The prognostic value of sNfL was compared with that of other known clinical prognostic factors using a Cox regression model and multivariate analysis. RESULTS: Serum neurofilament light chain levels were higher in ALS patients than in controls (P < 0.0001). Seven parameters were predictive of death in ALS: older age, bulbar onset, higher ALS Functional Rating Scale revised (ALSFRS-R) score, greater weight loss, lower maximal inspiratory pressure, forced vital capacity and higher sNfL levels. A Cox regression model showed that sNfL (P < 0.0001), weight loss (P = 0.040) and site at onset (P = 0.048) were independent predictive factors of death. In a sub-cohort restricted to 139 patients with complete spirometry data, sNfL level (P < 0.005) and forced vital capacity (P = 0.022) were independent factors predictive of death. In a subgroup of 142 patients in whom ALSFRS-R score was available at several time points, sNfL levels positively correlated with ALSFRS-R rate of decline (r = 0.571, P < 10-12 ). CONCLUSIONS: Higher sNfL concentration is a strong and independent prognostic factor of death in ALS as early as the time of diagnosis.
BACKGROUND AND PURPOSE: The prognostic value of serum neurofilament light chain (sNfL), a biomarker of neurodegeneration, compared to other prognostic factors of amyotrophic lateral sclerosis (ALS) at the time of diagnosis, remains unclear. METHODS: Sera from ALS patients were prospectively collected at the first diagnostic visit in our centre. sNfL levels were determined by single molecule array in 207 ALS patients and in 21 healthy controls. The prognostic value of sNfL was compared with that of other known clinical prognostic factors using a Cox regression model and multivariate analysis. RESULTS: Serum neurofilament light chain levels were higher in ALS patients than in controls (P < 0.0001). Seven parameters were predictive of death in ALS: older age, bulbar onset, higher ALS Functional Rating Scale revised (ALSFRS-R) score, greater weight loss, lower maximal inspiratory pressure, forced vital capacity and higher sNfL levels. A Cox regression model showed that sNfL (P < 0.0001), weight loss (P = 0.040) and site at onset (P = 0.048) were independent predictive factors of death. In a sub-cohort restricted to 139 patients with complete spirometry data, sNfL level (P < 0.005) and forced vital capacity (P = 0.022) were independent factors predictive of death. In a subgroup of 142 patients in whom ALSFRS-R score was available at several time points, sNfL levels positively correlated with ALSFRS-R rate of decline (r = 0.571, P < 10-12 ). CONCLUSIONS: Higher sNfL concentration is a strong and independent prognostic factor of death in ALS as early as the time of diagnosis.
Authors: Michael Benatar; Lanyu Zhang; Lily Wang; Volkan Granit; Jeffrey Statland; Richard Barohn; Andrea Swenson; John Ravits; Carlayne Jackson; Ted M Burns; Jaya Trivedi; Erik P Pioro; James Caress; Jonathan Katz; Jacob L McCauley; Rosa Rademakers; Andrea Malaspina; Lyle W Ostrow; Joanne Wuu Journal: Neurology Date: 2020-05-08 Impact factor: 9.910
Authors: Simon Witzel; Felix Frauhammer; Markus Otto; Albert C Ludolph; Petra Steinacker; David Devos; Pierre-François Pradat; Vincent Meininger; Steffen Halbgebauer; Patrick Oeckl; Joachim Schuster; Simon Anders; Johannes Dorst Journal: Transl Neurodegener Date: 2021-08-26 Impact factor: 8.014