Plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus
Abstract Background Neurofilament light chain protein (NFL), a marker of neuronal axonal degeneration, is increased in cerebrospinal fluid (CSF) of patients with idiopathic normal pressure hydrocephalus (iNPH). Assays for analysis of NFL in plasma are now widely available but plasma NFL has not been...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-07-01
|
| Series: | Fluids and Barriers of the CNS |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12987-023-00455-y |
| _version_ | 1827905317977980928 |
|---|---|
| author | A. Jeppsson Å. Sandelius A. Zettergren S. Kern I. Skoog K. Blennow H. Zetterberg C. Wikkelsø P. Hellström M. Tullberg |
| author_facet | A. Jeppsson Å. Sandelius A. Zettergren S. Kern I. Skoog K. Blennow H. Zetterberg C. Wikkelsø P. Hellström M. Tullberg |
| author_sort | A. Jeppsson |
| collection | DOAJ |
| description | Abstract Background Neurofilament light chain protein (NFL), a marker of neuronal axonal degeneration, is increased in cerebrospinal fluid (CSF) of patients with idiopathic normal pressure hydrocephalus (iNPH). Assays for analysis of NFL in plasma are now widely available but plasma NFL has not been reported in iNPH patients. Our aim was to examine plasma NFL in iNPH patients and to evaluate the correlation between plasma and CSF levels, and whether NFL levels are associated with clinical symptoms and outcome after shunt surgery. Methods Fifty iNPH patients with median age 73 who had their symptoms assessed with the iNPH scale and plasma and CSF NFL sampled pre- and median 9 months post-operatively. CSF plasma was compared with 50 healthy controls (HC) matched for age and gender. Concentrations of NFL were determined in plasma using an in-house Simoa method and in CSF using a commercially available ELISA method. Results Plasma NFL was elevated in patients with iNPH compared to HC (iNPH: 45 (30–64) pg/mL; HC: 33 (26–50) (median; Q1–Q3), p = 0.029). Plasma and CSF NFL concentrations correlated in iNPH patients both pre- and postoperatively (r = 0.67 and 0.72, p < 0.001). We found only weak correlations between plasma or CSF NFL and clinical symptoms and no associations with outcome. A postoperative NFL increase was seen in CSF but not in plasma. Conclusions Plasma NFL is increased in iNPH patients and concentrations correlate with CSF NFL implying that plasma NFL can be used to assess evidence of axonal degeneration in iNPH. This finding opens a window for plasma samples to be used in future studies of other biomarkers in iNPH. NFL is probably not a very useful marker of symptomatology or for prediction of outcome in iNPH. |
| first_indexed | 2024-03-13T00:40:54Z |
| format | Article |
| id | doaj.art-b04f5fdf546d4ad4ab16755ac118f9de |
| institution | Directory Open Access Journal |
| issn | 2045-8118 |
| language | English |
| last_indexed | 2024-03-13T00:40:54Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Fluids and Barriers of the CNS |
| spelling | doaj.art-b04f5fdf546d4ad4ab16755ac118f9de2023-07-09T11:21:55ZengBMCFluids and Barriers of the CNS2045-81182023-07-012011810.1186/s12987-023-00455-yPlasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalusA. Jeppsson0Å. Sandelius1A. Zettergren2S. Kern3I. Skoog4K. Blennow5H. Zetterberg6C. Wikkelsø7P. Hellström8M. Tullberg9Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University HospitalClinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of GothenburgNeuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of GothenburgNeuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of GothenburgNeuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of GothenburgClinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of GothenburgClinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of GothenburgHydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University HospitalHydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University HospitalHydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University HospitalAbstract Background Neurofilament light chain protein (NFL), a marker of neuronal axonal degeneration, is increased in cerebrospinal fluid (CSF) of patients with idiopathic normal pressure hydrocephalus (iNPH). Assays for analysis of NFL in plasma are now widely available but plasma NFL has not been reported in iNPH patients. Our aim was to examine plasma NFL in iNPH patients and to evaluate the correlation between plasma and CSF levels, and whether NFL levels are associated with clinical symptoms and outcome after shunt surgery. Methods Fifty iNPH patients with median age 73 who had their symptoms assessed with the iNPH scale and plasma and CSF NFL sampled pre- and median 9 months post-operatively. CSF plasma was compared with 50 healthy controls (HC) matched for age and gender. Concentrations of NFL were determined in plasma using an in-house Simoa method and in CSF using a commercially available ELISA method. Results Plasma NFL was elevated in patients with iNPH compared to HC (iNPH: 45 (30–64) pg/mL; HC: 33 (26–50) (median; Q1–Q3), p = 0.029). Plasma and CSF NFL concentrations correlated in iNPH patients both pre- and postoperatively (r = 0.67 and 0.72, p < 0.001). We found only weak correlations between plasma or CSF NFL and clinical symptoms and no associations with outcome. A postoperative NFL increase was seen in CSF but not in plasma. Conclusions Plasma NFL is increased in iNPH patients and concentrations correlate with CSF NFL implying that plasma NFL can be used to assess evidence of axonal degeneration in iNPH. This finding opens a window for plasma samples to be used in future studies of other biomarkers in iNPH. NFL is probably not a very useful marker of symptomatology or for prediction of outcome in iNPH.https://doi.org/10.1186/s12987-023-00455-yIdiopathic normal pressure hydrocephalusNeurofilament light chain proteinNFLBiomarkersCSFPlasma |
| spellingShingle | A. Jeppsson Å. Sandelius A. Zettergren S. Kern I. Skoog K. Blennow H. Zetterberg C. Wikkelsø P. Hellström M. Tullberg Plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus Fluids and Barriers of the CNS Idiopathic normal pressure hydrocephalus Neurofilament light chain protein NFL Biomarkers CSF Plasma |
| title | Plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus |
| title_full | Plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus |
| title_fullStr | Plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus |
| title_full_unstemmed | Plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus |
| title_short | Plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus |
| title_sort | plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus |
| topic | Idiopathic normal pressure hydrocephalus Neurofilament light chain protein NFL Biomarkers CSF Plasma |
| url | https://doi.org/10.1186/s12987-023-00455-y |
| work_keys_str_mv | AT ajeppsson plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT asandelius plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT azettergren plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT skern plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT iskoog plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT kblennow plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT hzetterberg plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT cwikkelsø plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT phellstrom plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus AT mtullberg plasmaandcerebrospinalfluidconcentrationsofneurofilamentlightproteincorrelateinpatientswithidiopathicnormalpressurehydrocephalus |