Cerebrospinal fluid levels of neurofilament light chain in multiple system atrophy relative to Parkinson’s disease: a meta-analysis

Hu, Xiaohui; Yang, Yan; Gong, Daokai

doi:10.1007/s10072-016-2783-7

Cited by 30 publications

(29 citation statements)

References 28 publications

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“…The most promising so far include plasma norepinephrine levels (Kaufmann et al, 2017b), plasma catecholaminergic vesicular storage levels (Goldstein et al, 2015), plasma and CSF neurofilament light chain (NfL) protein (Hansson et al, 2017; Hu et al, 2017), and plasma and CSF αSyn levels (Sun et al, 2014). Further research is required to confirm the sensitivity and specificity of these.…”

Section: Emerging Diagnostic Methodsmentioning

confidence: 99%

Diagnosis of multiple system atrophy

Palma

Norcliffe‐Kaufmann

Kaufmann

2018

Autonomic Neuroscience

126

114

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Multiple system atrophy (MSA) may be difficult to distinguish clinically from other disorders, particularly in the early stages of the disease. An autonomic-only presentation can be indistinguishable from pure autonomic failure. Patients presenting with parkinsonism may be misdiagnosed as having Parkinson disease. Patients presenting with the cerebellar phenotype of MSA can mimic other adult-onset ataxias due to alcohol, chemotherapeutic agents, lead, lithium, and toluene, or vitamin E deficiency, as well as paraneoplastic, autoimmune, or genetic ataxias. A careful medical history and meticulous neurological examination remain the cornerstone for the accurate diagnosis of MSA. Ancillary investigations are helpful to support the diagnosis, rule out potential mimics, and define therapeutic strategies. This review summarizes diagnostic investigations useful in the differential diagnosis of patients with suspected MSA. Currently used techniques include structural and functional brain imaging, cardiac sympathetic imaging, cardiovascular autonomic testing, olfactory testing, sleep study, urological evaluation, and dysphagia and cognitive assessments. Despite advances in the diagnostic tools for MSA in recent years and the availability of consensus criteria for clinical diagnosis, the diagnostic accuracy of MSA remains sub-optimal. As other diagnostic tools emerge, including skin biopsy, retinal biomarkers, blood and cerebrospinal fluid biomarkers, and advanced genetic testing, a more accurate and earlier recognition of MSA should be possible, even in the prodromal stages. This has important implications as misdiagnosis can result in inappropriate treatment, patient and family distress, and erroneous eligibility for clinical trials of disease-modifying drugs.

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Section: Emerging Diagnostic Methodsmentioning

confidence: 99%

Diagnosis of multiple system atrophy

Palma

Norcliffe‐Kaufmann

Kaufmann

2018

Autonomic Neuroscience

126

114

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“…Accordingly, the random-effect model was used when the heterogeneity test was P <0.05. 15 The data of CSF and blood NFL levels in MS patients compared with that in control subjects were extracted and pooled for separate meta-analysis. Sensitivity analysis and subgroup analysis were done to explore potential heterogeneity sources.…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, heterogeneity, pooled Std.MD, subgroup analysis, and funnel plots were calculated by Review Manager version 5.3 (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). 15 Also, separate regression of age, gender, sample size, and disease duration on Std.MD of the CSF and blood NFL levels in MS patients were calculated by the method-of-moments technique. Meta-regression was performed by STATA software (version 12.0, StataCorp, College Station, TX, USA).…”

Section: Methodsmentioning

confidence: 99%

Neurofilament light chain as a biological marker for multiple sclerosis: a meta-analysis study

Cai

Huang

2018

NDT

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PurposeThere is a need for biomarkers in multiple sclerosis (MS) to make an early diagnosis and monitor its progression. This study was designed to evaluate the value of neurofilament light (NFL) chain levels as cerebrospinal fluid (CSF) or blood biomarker in patients with MS by using a quantitative meta-analysis.MethodsThe PubMed, Embase, and Web of Science databases were systematically searched for relevant studies. Articles in English that evaluated the utility of NFL in CSF and blood in the diagnosis of MS were included. Data were extracted by two independent researchers. Mean (± SD) NFL concentration for MS patients and control subjects were extracted. Review Manager version 5.3 software with a continuous-variable random-effects model was used to summarize the diagnostic indexes from eligible studies. The Newcastle–Ottawa Scale was used for assessing the quality and risk of bias of included studies. In addition, subgroup analysis and meta-regression were performed to assess potential heterogeneity sources.ResultsThe meta-analysis included 13 articles containing results from 15 studies. A total of 10 studies measured NFL levels in CSF and five studies measured NFL levels in blood. Data were available on 795 participants in CSF and 1,856 participants in blood. Moreover, CSF NFL in MS patients was higher than that in healthy control groups (pooled standard mean difference [Std.MD]=0.88, 95% CI [0.50, 1.26], P<0.00001) and serum NFL in MS patients was higher than that in control subjects (pooled Std.MD=0.47, 95% CI [0.24, 0.71], P<0.0001).ConclusionNFL chain has significantly increased in MS patients, which substantially strengthens the clinical evidence of the NFL in MS. The NFL may be used as a prognostic biomarker to monitor disease progression, disease activity, and treatment efficacy in the future.

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“…Neurofilament light chains (NFL) also have the potential to differentiate PD from MSA or PSP, and this is supported by meta-analyses [ 57 , 58 , 59 , 60 ]. NFL elevation was observed in MSA, PSP, and corticobasal degeneration.…”

Section: Resultsmentioning

confidence: 98%

Cerebrospinal Fluid Biomarkers in Parkinson’s Disease: A Critical Overview of the Literature and Meta-Analyses

et al. 2020

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Parkinson’s disease (PD) is a common neurodegenerative disorder; however, well-established biochemical markers have not yet been identified. This review article covers several candidate cerebrospinal fluid (CSF) biomarkers for PD based on the recent literature and meta-analysis data. The decrease of α-synuclein in PD is supported by meta-analyses with modest reproducibility, and a decrease of amyloid β42 is seen as a prognostic marker for cognitive decline. Tau, phosphorylated tau (p-tau), and neurofilament light chains have been used to discriminate PD from other neurodegenerative disorders. This article also describes more hopeful biochemical markers, such as neurotransmitters, oxidative stress markers, and other candidate biomarkers.

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Cerebrospinal fluid levels of neurofilament light chain in multiple system atrophy relative to Parkinson’s disease: a meta-analysis

Cited by 30 publications

References 28 publications

Diagnosis of multiple system atrophy

Diagnosis of multiple system atrophy

Neurofilament light chain as a biological marker for multiple sclerosis: a meta-analysis study

Cerebrospinal Fluid Biomarkers in Parkinson’s Disease: A Critical Overview of the Literature and Meta-Analyses

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