A new study of over 3000 people, has shown for the first time that a single biomarker can accurately indicate the presence of underlying neurodegeneration in people with cognitive issues.
Published in Nature Communications and part-funded by the NIHR Maudsley Biomedical Research Centre, the research determined a set of age-related cut-off levels of NfL which could inform its potential use in primary care settings through a simple blood test.
Joint Senior Author on the study, Dr Abdul Hye from the NIHR Maudsley Biomedical Research Centre at King’s College London and South London and Maudsley NHS Foundation Trust said: ‘For the first time we have shown across a number of disorders that a single biomarker can indicate the presence of underlying neurodegeneration with excellent accuracy. Though it is not specific for any one disorder, it could help in services such as memory clinics as a rapid screening tool to identify whether memory, thinking or psychiatric problems are a result of neurodegeneration.’
Neurodegenerative diseases are debilitating conditions that result in ongoing degeneration or death of nerve cells, leading to problems in thought, attention and memory. There are currently around 850,000 people with dementia in the UK which is projected to rise to 1.6 million by 2040. In order to help identify the onset of these debilitating diseases and put in place preventative measures as early as possible there has been a drive to develop reliable and accessible biomarkers that can recognise or rule out whether the processes in the brain that are responsible for neurodegeneration are occurring.
Current biomarkers used to identify neurodegenerative disorders are taken from the fluid that surrounds the brain and spinal column (cerebrospinal fluid — CSF) which has to be extracted using an invasive procedure called lumbar puncture. Advances have been made to use biomarkers from the blood which would provide a more accessible and comfortable assessment. A central and irreversible feature in many neurodegenerative disorders is damage to the nerve fibre which results in the release of neurofilament light chain (NfL). Using ultrasensitive tests, NfL can be detected in blood at low levels and is increased in a number of disorders, unlike phosphorylated tau which is specific for Alzheimer’s disease. This means NfL can be of use in the diagnostic process of many neurodegenerative diseases most notably in this study Down’s syndrome dementia, ALS and frontotemporal dementia.
Co-author Professor Ammar Al-Chalabi from at King’s College London and co-lead of the Psychosis and Neuropsychiatry research theme at the NIHR Maudsley BRC. said ‘For neurodegenerative diseases like Alzheimer’s, Parkinson’s or motor neuron disease, a blood test to allow early diagnosis and help us monitor disease progression and response to treatment would be very helpful. Neurofilament light chain is a promising biomarker that could speed diagnosis of neurodegenerative diseases and shorten clinical trials.’
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Materials provided by King’s College London. Note: Content may be edited for style and length.