Neurofilament Light Chain as a Potential Biomarker in Plasma for Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and a Meta-Analysis

Background: Plasma neurofilament light (NfL) is an intermediate filamentous protein involved in stabilizing axonal structure and promoting axon growth. Recent clinical studies have reported increased NfL levels in the plasma of Alzheimer’s disease (AD) patients and patients with mild cognitive impai...

Full description

Bibliographic Details
Main Authors: Zhenyi Fan, Xiaoxia Liu, Jie Liu, Caijing Chen, Min Zhou
Format: Article
Language:English
Published: IMR Press 2023-06-01
Series:Journal of Integrative Neuroscience
Subjects:
Online Access:https://www.imrpress.com/journal/JIN/22/4/10.31083/j.jin2204085
_version_ 1797768940336709632
author Zhenyi Fan
Xiaoxia Liu
Jie Liu
Caijing Chen
Min Zhou
author_facet Zhenyi Fan
Xiaoxia Liu
Jie Liu
Caijing Chen
Min Zhou
author_sort Zhenyi Fan
collection DOAJ
description Background: Plasma neurofilament light (NfL) is an intermediate filamentous protein involved in stabilizing axonal structure and promoting axon growth. Recent clinical studies have reported increased NfL levels in the plasma of Alzheimer’s disease (AD) patients and patients with mild cognitive impairment (MCI). This study used meta-analysis to evaluate the potential of plasma NfL as a biomarker for patients with AD and MCI. Methods: PubMed, Embase, and Web of Science databases were systematically searched for studies of plasma NfL levels in AD and MCI, and a meta-analysis was employed to identify whether it was suited as a reliable biomarker and discrimination of healthy controls. Results: A total of 24 published articles that included 2397 AD and 3242 MCI patients were analysed. The level of plasma NfL was significantly increased in patients with AD and MCI when compared with healthy control subjects (standard mean difference [SMD]: 14.33 [12.42–16.24], z = 14.71, p < 0.00001; SMD: 4.95 [3.82–6.80], z = 8.59, p < 0.00001) and higher in AD patients than MCI patients (SMD: 9.32 [8.07–10.57], z = 14.62, p < 0.00001). Meta-regression analysis showed a negative relationship between Mini-Mental State Examination (MMSE) scores and plasma NfL levels in MCI patients (slope = –0.399 [95% confidence interval (CI): –0.518 to –0.281], p < 0.05). Conclusions: The meta-analysis suggested that NfL levels increased in the plasma of patients with AD and MCI and were associated with cognitive decline. Results provide the clinical evidence to support plasma NfL as a cognitive biomarker for AD and MCI.
first_indexed 2024-03-12T21:00:38Z
format Article
id doaj.art-056abb65f53d4cb582efd7e392fa977e
institution Directory Open Access Journal
issn 0219-6352
language English
last_indexed 2024-03-12T21:00:38Z
publishDate 2023-06-01
publisher IMR Press
record_format Article
series Journal of Integrative Neuroscience
spelling doaj.art-056abb65f53d4cb582efd7e392fa977e2023-07-31T07:12:11ZengIMR PressJournal of Integrative Neuroscience0219-63522023-06-012248510.31083/j.jin2204085S0219-6352(23)00511-9Neurofilament Light Chain as a Potential Biomarker in Plasma for Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and a Meta-AnalysisZhenyi Fan0Xiaoxia Liu1Jie Liu2Caijing Chen3Min Zhou4Department of Neurology, Ningbo NO.2 Hospital, 315000 Ningbo, Zhejiang, ChinaDepartment of Neurology, Ningbo NO.2 Hospital, 315000 Ningbo, Zhejiang, ChinaDepartment of Geriatrics, Ningbo NO.2 Hospital, 315000 Ningbo, Zhejiang, ChinaDepartment of Geriatrics, Ningbo NO.2 Hospital, 315000 Ningbo, Zhejiang, ChinaDepartment of Neurology, Ningbo NO.2 Hospital, 315000 Ningbo, Zhejiang, ChinaBackground: Plasma neurofilament light (NfL) is an intermediate filamentous protein involved in stabilizing axonal structure and promoting axon growth. Recent clinical studies have reported increased NfL levels in the plasma of Alzheimer’s disease (AD) patients and patients with mild cognitive impairment (MCI). This study used meta-analysis to evaluate the potential of plasma NfL as a biomarker for patients with AD and MCI. Methods: PubMed, Embase, and Web of Science databases were systematically searched for studies of plasma NfL levels in AD and MCI, and a meta-analysis was employed to identify whether it was suited as a reliable biomarker and discrimination of healthy controls. Results: A total of 24 published articles that included 2397 AD and 3242 MCI patients were analysed. The level of plasma NfL was significantly increased in patients with AD and MCI when compared with healthy control subjects (standard mean difference [SMD]: 14.33 [12.42–16.24], z = 14.71, p < 0.00001; SMD: 4.95 [3.82–6.80], z = 8.59, p < 0.00001) and higher in AD patients than MCI patients (SMD: 9.32 [8.07–10.57], z = 14.62, p < 0.00001). Meta-regression analysis showed a negative relationship between Mini-Mental State Examination (MMSE) scores and plasma NfL levels in MCI patients (slope = –0.399 [95% confidence interval (CI): –0.518 to –0.281], p < 0.05). Conclusions: The meta-analysis suggested that NfL levels increased in the plasma of patients with AD and MCI and were associated with cognitive decline. Results provide the clinical evidence to support plasma NfL as a cognitive biomarker for AD and MCI.https://www.imrpress.com/journal/JIN/22/4/10.31083/j.jin2204085alzheimer's diseasemild cognitive impairmentneurofilament light chainmeta-analysis
spellingShingle Zhenyi Fan
Xiaoxia Liu
Jie Liu
Caijing Chen
Min Zhou
Neurofilament Light Chain as a Potential Biomarker in Plasma for Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and a Meta-Analysis
Journal of Integrative Neuroscience
alzheimer's disease
mild cognitive impairment
neurofilament light chain
meta-analysis
title Neurofilament Light Chain as a Potential Biomarker in Plasma for Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and a Meta-Analysis
title_full Neurofilament Light Chain as a Potential Biomarker in Plasma for Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and a Meta-Analysis
title_fullStr Neurofilament Light Chain as a Potential Biomarker in Plasma for Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and a Meta-Analysis
title_full_unstemmed Neurofilament Light Chain as a Potential Biomarker in Plasma for Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and a Meta-Analysis
title_short Neurofilament Light Chain as a Potential Biomarker in Plasma for Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and a Meta-Analysis
title_sort neurofilament light chain as a potential biomarker in plasma for alzheimer s disease and mild cognitive impairment a systematic review and a meta analysis
topic alzheimer's disease
mild cognitive impairment
neurofilament light chain
meta-analysis
url https://www.imrpress.com/journal/JIN/22/4/10.31083/j.jin2204085
work_keys_str_mv AT zhenyifan neurofilamentlightchainasapotentialbiomarkerinplasmaforalzheimersdiseaseandmildcognitiveimpairmentasystematicreviewandametaanalysis
AT xiaoxialiu neurofilamentlightchainasapotentialbiomarkerinplasmaforalzheimersdiseaseandmildcognitiveimpairmentasystematicreviewandametaanalysis
AT jieliu neurofilamentlightchainasapotentialbiomarkerinplasmaforalzheimersdiseaseandmildcognitiveimpairmentasystematicreviewandametaanalysis
AT caijingchen neurofilamentlightchainasapotentialbiomarkerinplasmaforalzheimersdiseaseandmildcognitiveimpairmentasystematicreviewandametaanalysis
AT minzhou neurofilamentlightchainasapotentialbiomarkerinplasmaforalzheimersdiseaseandmildcognitiveimpairmentasystematicreviewandametaanalysis