Serum Neurofilament light correlates with CADASIL disease severity and survival.

Abstract

Objective:

To validate whether serum Neurofilament Light-chain (NfL) levels correlate with disease severity in CADASIL, and to determine whether serum NfL predicts disease progression and survival.

Methods:

Fourty-one (pre-) manifest individuals with CADASIL causing NOTCH3 mutations and 22 healthy controls were recruited from CADASIL families. At baseline, MRI-lesion load and clinical severity was determined and serum was stored. Disease progression was measured in 30/41 patients at 7-year follow-up, and survival of all individuals was determined at 17-year follow-up. Serum NfL levels were quantified using an ultra-sensitive molecule array. Generalized estimated equation regression (GEE) was used to analyze association between serum NfL, MRI-lesion load, disease severity, and disease progression. With GEE-based Cox regression, survival was analyzed.

Results:

At baseline, serum NfL levels correlated with MRI-lesion load [lacune count (s = 0.64, P = 0.002), brain atrophy (r = -0.50, P = 0.001), and microbleed count (s = 0.48, P = 0.044)], cognition [CAMCOG (s = -0.45, P = 0.010), MMSE (r = -0.61, P = 0.003), GIT (r = -0.61, P < 0.001), TMT-A (r = 0.70, P < 0.001)) and disability (mRS (r = 0.70, P = 0.002)]. Baseline serum NfL predicted 7-year changes in disability (B = 0.34, P < 0.001) and cognition (CAMCOG B = -4.94, P = 0.032), as well as 17-year survival. Higher NfL levels were associated with increased mortality (HR=1.8 per twofold increase in NfL levels, P = 0.006).

Interpretation:

Serum NfL levels correlate with disease severity, disease progression and 17-year survival in CADASIL patients. Serum NfL is a promising biomarker to monitor and predict disease course in CADASIL, as well as potentially assessing therapeutic response in future clinical trials.

• Authors: Gido Gravesteijn, Julie W Rutten, Inge M W Verberk, Stefan Böhringer, Michael K Liem, Jeroen van der Grond, Annemieke Aartsma-Rus, Charlotte E Teunissen, Saskia A J Lesnik Oberstein
• Journal: Annals of clinical and translational neurology (Ann Clin Transl Neurol) Vol. 6 Issue 1 Pg. 46-56 (01 2019) ISSN: 2328-9503 [Print] United States
• PMID: 30656183 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Neurofilament Proteins

Topics

• Adult
• Biomarkers (blood)
• CADASIL (blood, diagnosis, pathology)
• Cross-Sectional Studies
• Disease Progression
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Neurofilament Proteins (blood)
• Sensitivity and Specificity
• Severity of Illness Index