Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology

作者：Claire Bridel, Wessel N. van Wieringen, Henrik Zetterberg, Betty M. Tijms, Charlotte E. Teunissen, and the NFL Group, José C. Álvarez‐Cermeño, Ulf Andréasson, Markus Axelsson, David Bäckström, Aleš Bartoš, Maria Bjerke, Kaj Blennow, Adam L. Boxer, Lou Brundin, Joachim Burman, Tove Christensen, L Fialová, Lars Forsgren, Jette Lautrup Frederiksen, Magnus Gisslén, Elizabeth Gray, Martin Gunnarsson, Sara Hall, Oskar Hansson, Megan K. Herbert, Joel Jakobsson, Jan Jessen-Krut, Shorena Janelidze, Gudmundur Johannsson, Michael Jonsson, Ludwig Kappos, Mohsen Khademi, Michael Khalil, Jens Kühle, Mikael Landén, Ville Leinonen, Giancarlo Logroscino, Ching‐Hua Lu, Jan Lycke, Nadia Magdalinou, Andrea Malaspina, Niklas Mattsson, Lieke Meeter, Sanjay R. Mehta, Signe Modvig, Tomas Olsson, Ross W. Paterson, Josué Pérez‐Santiago, Fredrik Piehl, Yolande A.L. Pijnenburg, Okko T. Pyykkö, Óskar Ragnarsson, Julio C. Rojas, Jeppe Romme Christensen, Linda Sandberg, Carole Scherling, Jonathan M. Schott, Finn Sellebjerg, Isabella Laura Simone, Tobias Skillbäck, Morten Stilund, Peter Sundström, Anders Svenningsson, Rosanna Tortelli, Carla Tortorella, Alessandro Trentini, Maria Troiano, Martin R. Turner, John C. van Swieten, Mattias Vågberg, Marcel M. Verbeek, Luisa María Villar, Pieter Jelle Visser, Anders Wallin, Andreas Weiss, Carsten Wikkelsø, Edward J. Wild · 发表于：JAMA Neurology · 年份：2019 · DOI：10.1001/jamaneurol.2019.1534 · 被引用次数：783 · 研究领域：Prion Diseases and Protein Misfolding、Neurological diseases and metabolism、Skin and Cellular Biology Research

IMPORTANCE: Neurofilament light protein (NfL) is elevated in cerebrospinal fluid (CSF) of a number of neurological conditions compared with healthy controls (HC) and is a candidate biomarker for neuroaxonal damage. The influence of age and sex is largely unknown, and levels across neurological disorders have not been compared systematically to date. OBJECTIVES: To assess the associations of age, sex, and diagnosis with NfL in CSF (cNfL) and to evaluate its potential in discriminating clinically similar conditions. DATA SOURCES: PubMed was searched for studies published between January 1, 2006, and January 1, 2016, reporting cNfL levels (using the search terms neurofilament light and cerebrospinal fluid) in neurological or psychiatric conditions and/or in HC. STUDY SELECTION: Studies reporting NfL levels measured in lumbar CSF using a commercially available immunoassay, as well as age and sex. DATA EXTRACTION AND SYNTHESIS: Individual-level data were requested from study authors. Generalized linear mixed-effects models were used to estimate the fixed effects of age, sex, and diagnosis on log-transformed NfL levels, with cohort of origin modeled as a random intercept. MAIN OUTCOME AND MEASURE: The cNfL levels adjusted for age and sex across diagnoses. RESULTS: Data were collected for 10 059 individuals (mean [SD] age, 59.7 [18.8] years; 54.1% female). Thirty-five diagnoses were identified, including inflammatory diseases of the central nervous system (n = 2795), dementias and p...