Matthew J Y Kang, Dhamidhu Eratne, Hannah Dobson, Charles B Malpas, Michael Keem, Courtney Lewis, Jasleen Grewal, Vivian Tsoukra, Christa Dang, Ramon Mocellin, Tomas Kalincik, Alexander F Santillo, Henrik Zetterberg, Kaj Blennow, Christiane Stehmann, Shiji Varghese, Qiao-Xin Li, Colin L Masters, Steven Collins, Samuel F Berkovic, Andrew Evans, Wendy Kelso, Sarah Farrand, Samantha M Loi, Mark Walterfang, Dennis Velakoulis
{"title":"脑脊液神经丝光可预测精神病和神经退行性疾病患者的纵向诊断变化。","authors":"Matthew J Y Kang, Dhamidhu Eratne, Hannah Dobson, Charles B Malpas, Michael Keem, Courtney Lewis, Jasleen Grewal, Vivian Tsoukra, Christa Dang, Ramon Mocellin, Tomas Kalincik, Alexander F Santillo, Henrik Zetterberg, Kaj Blennow, Christiane Stehmann, Shiji Varghese, Qiao-Xin Li, Colin L Masters, Steven Collins, Samuel F Berkovic, Andrew Evans, Wendy Kelso, Sarah Farrand, Samantha M Loi, Mark Walterfang, Dennis Velakoulis","doi":"10.1017/neu.2023.25","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>People with neuropsychiatric symptoms often experience delay in accurate diagnosis. Although cerebrospinal fluid neurofilament light (CSF NfL) shows promise in distinguishing neurodegenerative disorders (ND) from psychiatric disorders (PSY), its accuracy in a diagnostically challenging cohort longitudinally is unknown.</p><p><strong>Methods: </strong>We collected longitudinal diagnostic information (mean = 36 months) from patients assessed at a neuropsychiatry service, categorising diagnoses as ND/mild cognitive impairment/other neurological disorders (ND/MCI/other) and PSY. We pre-specified NfL > 582 pg/mL as indicative of ND/MCI/other.</p><p><strong>Results: </strong>Diagnostic category changed from initial to final diagnosis for 23% (49/212) of patients. NfL predicted the final diagnostic category for 92% (22/24) of these and predicted final diagnostic category overall (ND/MCI/other vs. PSY) in 88% (187/212), compared to 77% (163/212) with clinical assessment alone.</p><p><strong>Conclusions: </strong>CSF NfL improved diagnostic accuracy, with potential to have led to earlier, accurate diagnosis in a real-world setting using a pre-specified cut-off, adding weight to translation of NfL into clinical practice.</p>","PeriodicalId":7066,"journal":{"name":"Acta Neuropsychiatrica","volume":" ","pages":"17-28"},"PeriodicalIF":3.8000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cerebrospinal fluid neurofilament light predicts longitudinal diagnostic change in patients with psychiatric and neurodegenerative disorders.\",\"authors\":\"Matthew J Y Kang, Dhamidhu Eratne, Hannah Dobson, Charles B Malpas, Michael Keem, Courtney Lewis, Jasleen Grewal, Vivian Tsoukra, Christa Dang, Ramon Mocellin, Tomas Kalincik, Alexander F Santillo, Henrik Zetterberg, Kaj Blennow, Christiane Stehmann, Shiji Varghese, Qiao-Xin Li, Colin L Masters, Steven Collins, Samuel F Berkovic, Andrew Evans, Wendy Kelso, Sarah Farrand, Samantha M Loi, Mark Walterfang, Dennis Velakoulis\",\"doi\":\"10.1017/neu.2023.25\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>People with neuropsychiatric symptoms often experience delay in accurate diagnosis. Although cerebrospinal fluid neurofilament light (CSF NfL) shows promise in distinguishing neurodegenerative disorders (ND) from psychiatric disorders (PSY), its accuracy in a diagnostically challenging cohort longitudinally is unknown.</p><p><strong>Methods: </strong>We collected longitudinal diagnostic information (mean = 36 months) from patients assessed at a neuropsychiatry service, categorising diagnoses as ND/mild cognitive impairment/other neurological disorders (ND/MCI/other) and PSY. We pre-specified NfL > 582 pg/mL as indicative of ND/MCI/other.</p><p><strong>Results: </strong>Diagnostic category changed from initial to final diagnosis for 23% (49/212) of patients. NfL predicted the final diagnostic category for 92% (22/24) of these and predicted final diagnostic category overall (ND/MCI/other vs. PSY) in 88% (187/212), compared to 77% (163/212) with clinical assessment alone.</p><p><strong>Conclusions: </strong>CSF NfL improved diagnostic accuracy, with potential to have led to earlier, accurate diagnosis in a real-world setting using a pre-specified cut-off, adding weight to translation of NfL into clinical practice.</p>\",\"PeriodicalId\":7066,\"journal\":{\"name\":\"Acta Neuropsychiatrica\",\"volume\":\" \",\"pages\":\"17-28\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Neuropsychiatrica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/neu.2023.25\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/4/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Neuropsychiatrica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/neu.2023.25","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/28 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
Cerebrospinal fluid neurofilament light predicts longitudinal diagnostic change in patients with psychiatric and neurodegenerative disorders.
Objective: People with neuropsychiatric symptoms often experience delay in accurate diagnosis. Although cerebrospinal fluid neurofilament light (CSF NfL) shows promise in distinguishing neurodegenerative disorders (ND) from psychiatric disorders (PSY), its accuracy in a diagnostically challenging cohort longitudinally is unknown.
Methods: We collected longitudinal diagnostic information (mean = 36 months) from patients assessed at a neuropsychiatry service, categorising diagnoses as ND/mild cognitive impairment/other neurological disorders (ND/MCI/other) and PSY. We pre-specified NfL > 582 pg/mL as indicative of ND/MCI/other.
Results: Diagnostic category changed from initial to final diagnosis for 23% (49/212) of patients. NfL predicted the final diagnostic category for 92% (22/24) of these and predicted final diagnostic category overall (ND/MCI/other vs. PSY) in 88% (187/212), compared to 77% (163/212) with clinical assessment alone.
Conclusions: CSF NfL improved diagnostic accuracy, with potential to have led to earlier, accurate diagnosis in a real-world setting using a pre-specified cut-off, adding weight to translation of NfL into clinical practice.
期刊介绍：
Acta Neuropsychiatrica is an international journal focussing on translational neuropsychiatry. It publishes high-quality original research papers and reviews. The Journal''s scope specifically highlights the pathway from discovery to clinical applications, healthcare and global health that can be viewed broadly as the spectrum of work that marks the pathway from discovery to global health.
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