Blood Neurofilament Light Chain in Different Types of Dementia.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY Current Alzheimer research Pub Date : 2023-01-01 DOI:10.2174/1567205020666230601123123

Lihua Gu, Hao Shu, Yanjuan Wang, Pan Wang

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引用次数: 1

Abstract

Aims: The study aimed to evaluate diagnostic values of circulating neurofilament light chain (NFL) levels in different types of dementia.

Background: Previous studies reported inconsistent change of blood NFL for different types of dementia, including Alzheimer's disease (AD), frontotemporal dementia (FTD), Parkinson's disease dementia (PDD) and Creutzfeldt-Jakob disease (CJD) and Lewy body dementia (LBD).

Objective: Meta-analysis was conducted to summarize the results of studies evaluating diagnostic values of circulating NFL levels in different types of dementia to enhance the strength of evidence.

Methods: Articles evaluating change in blood NFL levels in dementia and published before July 2022 were searched on the following databases (PubMed, Web of Science, EMBASE, Medline and Google Scholar). The computed results were obtained by using STATA 12.0 software.

Results: AD patients showed increased NFL concentrations in serum and plasma, compared to healthy controls (HC) (standard mean difference (SMD) = 1.09, 95% confidence interval (CI): 0.48, 1.70, I² = 97.4%, p < 0.001). In AD patients, higher NFL concentrations in serum and plasma were associated with reduced cerebrospinal fluid (CSF) Aβ_1-42, increased CSF t-tau, increased CSF p-tau, reduced Mini-Mental State Examination (MMSE) and decreased memory. Additionally, mild cognitive impairment (MCI) showed elevated NFL concentrations in serum and plasma, compared to HC (SMD = 0.53, 95% CI: 0.18, 0.87, I² = 93.8%, p < 0.001). However, in MCI, no significant association was found between NFL concentrations in serum, plasma and memory or visuospatial function. No significant difference was found between preclinical AD and HC (SMD = 0.18, 95% CI: -0.10, 0.47, I² = 0.0%, p = 0.438). FTD patients showed increased NFL concentrations in serum and plasma, compared to HC (SMD = 1.08, 95% CI: 0.72, 1.43, I² = 83.3%, p < 0.001). Higher NFL concentrations in serum and plasma were associated with increased CSF NFL in FTD. Additionally, the pooled parameters calculated were as follows: sensitivity, 0.82 (95% CI: 0.72, 0.90); specificity, 0.91 (95% CI: 0.83, 0.96). CJD patients showed increased NFL concentrations in serum and plasma, compared to HC. No significant difference in NFL level in serum and plasma was shown between AD and FTD (SMD = -0.03, 95% CI: -0.77, 0.72, I² = 83.3%, p = 0.003).

Conclusion: In conclusion, the study suggested abnormal blood NFL level in AD and MCI, but not in preclinical AD. FTD and CJD showed abnormal blood NFL levels.

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不同类型痴呆的血神经丝轻链。

目的:探讨循环神经丝轻链(NFL)水平对不同类型痴呆的诊断价值。背景:以往的研究报道了不同类型痴呆的血液NFL变化不一致，包括阿尔茨海默病(AD)、额颞叶痴呆(FTD)、帕金森病痴呆(PDD)、克雅氏病(CJD)和路易体痴呆(LBD)。目的:通过荟萃分析，总结评价循环NFL水平对不同类型痴呆诊断价值的研究结果，以增强证据的强度。方法:在以下数据库(PubMed, Web of Science, EMBASE, Medline和Google Scholar)中检索2022年7月之前发表的评估痴呆患者血液NFL水平变化的文章。计算结果采用STATA 12.0软件进行计算。结果:与健康对照(HC)相比，AD患者血清和血浆中NFL浓度升高(标准均差(SMD) = 1.09, 95%可信区间(CI): 0.48, 1.70, I2 = 97.4%， p < 0.001)。在AD患者中，血清和血浆中较高的NFL浓度与脑脊液(CSF) Aβ1-42减少、CSF t-tau升高、CSF p-tau升高、迷你精神状态检查(MMSE)减少和记忆力下降相关。此外，与HC相比，轻度认知障碍(MCI)患者血清和血浆中NFL浓度升高(SMD = 0.53, 95% CI: 0.18, 0.87, I2 = 93.8%， p < 0.001)。然而，在MCI中，血清、血浆中NFL浓度与记忆或视觉空间功能之间没有显著关联。临床前AD与HC之间无显著差异(SMD = 0.18, 95% CI: -0.10, 0.47, I2 = 0.0%， p = 0.438)。与HC相比，FTD患者血清和血浆中NFL浓度升高(SMD = 1.08, 95% CI: 0.72, 1.43, I2 = 83.3%， p < 0.001)。FTD患者血清和血浆中NFL浓度升高与CSF NFL升高相关。此外，计算的合并参数如下:敏感性，0.82 (95% CI: 0.72, 0.90);特异性为0.91 (95% CI: 0.83, 0.96)。与HC相比，CJD患者血清和血浆中NFL浓度升高。AD和FTD患者血清和血浆NFL水平无显著差异(SMD = -0.03, 95% CI: -0.77, 0.72, I2 = 83.3%， p = 0.003)。结论:本研究提示AD和MCI患者血NFL水平异常，而临床前AD患者血NFL水平异常。FTD和CJD表现为血NFL水平异常。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Alzheimer research 医学-神经科学

CiteScore

4.00

自引率

4.80%

发文量

审稿时长

4-8 weeks

期刊介绍： Current Alzheimer Research publishes peer-reviewed frontier review, research, drug clinical trial studies and letter articles on all areas of Alzheimer’s disease. This multidisciplinary journal will help in understanding the neurobiology, genetics, pathogenesis, and treatment strategies of Alzheimer’s disease. The journal publishes objective reviews written by experts and leaders actively engaged in research using cellular, molecular, and animal models. The journal also covers original articles on recent research in fast emerging areas of molecular diagnostics, brain imaging, drug development and discovery, and clinical aspects of Alzheimer’s disease. Manuscripts are encouraged that relate to the synergistic mechanism of Alzheimer''s disease with other dementia and neurodegenerative disorders. Book reviews, meeting reports and letters-to-the-editor are also published. The journal is essential reading for researchers, educators and physicians with interest in age-related dementia and Alzheimer’s disease. Current Alzheimer Research provides a comprehensive ''bird''s-eye view'' of the current state of Alzheimer''s research for neuroscientists, clinicians, health science planners, granting, caregivers and families of this devastating disease.