Cerebrospinal fluid neurofilament light chain differentiates primary psychiatric disorders from rapidly progressive, Alzheimer&#39;s disease and frontotemporal disorders in clinical settings

Eratne, D; Loi, SM; Li, QX; Stehmann, C; Malpas, CB; Santillo, A; Janelidze, S; Cadwallader, C; Walia, N; Ney, B; Lewis, V; Senesi, M; Fowler, C; McGlade, A; Varghese, S; Ravanfar, P; Kelso, W; Farrand, S; Keem, M; Kang, M; Goh, AMY; Dhiman, K; Gupta, V; Watson, R; Yassi, N; Kaylor-Hughes, C; Kanaan, R; Perucca, P; Dobson, H; Vivash, L; Ali, R; O&#39;Brien, TJ; Hansson, O; Zetterberg, H; Blennow, K; Walterfang, M; Masters, CL; Berkovic, SF; Collins, S; Velakoulis, D; MiND Study Group,

Cerebrospinal fluid neurofilament light chain differentiates primary psychiatric disorders from rapidly progressive, Alzheimer's disease and frontotemporal disorders in clinical settings

Author(s): Eratne, D; Loi, SM; Li, QX; Stehmann, C; Malpas, CB; Santillo, A; Janelidze, S; Cadwallader, C; Walia, N; Ney, B; Lewis, V; Senesi, M; Fowler, C; McGlade, A; Varghese, S; Ravanfar, P; Kelso, W; Farrand, S; Keem, M; Kang, M; Goh, AMY; Dhiman, K; Gupta, V; Watson, R; Yassi, N; Kaylor-Hughes, C; Kanaan, R; Perucca, P; Dobson, H; Vivash, L; Ali, R; O'Brien, TJ; Hansson, O; Zetterberg, H; Blennow, K; Walterfang, M; Masters, CL; Berkovic, SF; Collins, S; Velakoulis, D; MiND Study Group,;
Details: Publication Year 2022-11,Volume 18,Issue #11,Page 2218-2233
Journal Title: Alzheimer's & Dementia
Abstract: INTRODUCTION: Many patients with cognitive and neuropsychiatric symptoms face diagnostic delay and misdiagnosis. We investigated whether cerebrospinal fluid (CSF) neurofilament light (NfL) and total-tau (t-tau) could assist in the clinical scenario of differentiating neurodegenerative (ND) from psychiatric disorders (PSY), and rapidly progressive disorders. METHODS: Biomarkers were examined in patients from specialist services (ND and PSY) and a national Creutzfeldt-Jakob registry (Creutzfeldt-Jakob disease [CJD] and rapidly progressive dementias/atypically rapid variants of common ND, RapidND). RESULTS: A total of 498 participants were included: 197 ND, 67 PSY, 161 CJD, 48 RapidND, and 20 controls. NfL was elevated in ND compared to PSY and controls, with highest levels in CJD and RapidND. NfL distinguished ND from PSY with 95%/78% positive/negative predictive value, 92%/87% sensitivity/specificity, 91% accuracy. NfL outperformed t-tau in most real-life clinical diagnostic dilemma scenarios, except distinguishing CJD from RapidND. DISCUSSION: We demonstrated strong generalizable evidence for the diagnostic utility of CSF NfL in differentiating ND from psychiatric disorders, with high accuracy.
Keywords: Humans; *Alzheimer Disease/diagnosis/cerebrospinal fluid; Delayed Diagnosis; Intermediate Filaments; tau Proteins/cerebrospinal fluid; *Creutzfeldt-Jakob Syndrome/diagnosis/cerebrospinal fluid; Biomarkers/cerebrospinal fluid; *Mental Disorders
Research Division(s): Population Health And Immunity
PubMed ID: 35102694
Publisher's Version: https://doi.org/10.1002/alz.12549
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-02-24 09:21:03

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