NfL levels can predict cognitive decline and changes in imaging

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Plasma neurofilament light (NfL) may be useful in predicting cognitive decline and brain changes in the area, according to study results presented during the American Academy of Neurology (AAN) Annual Virtual Meeting 2021, April 17-22, 2021 imaging be effective.

Neuroimaging measurements of cortical thickness, cortical atrophy, and white matter hyperintensity and integrity have been associated with elevated plasma T-tau and NfL levels. The study’s researchers wanted to compare how T-tau protein and plasma NfL, proven blood-based biomarkers for neurodegeneration, correlate with cognition and certain imaging measures.

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This study included a total of 995 patients who participated in the Mayo Clinic Study on Aging. Patients without a diagnosis of dementia and with concurrent plasma and T-tau protein, cognitive status and neuroimaging data. Patients completed follow-up every 15 months for a median of 6.2 years, with researchers measuring NfL and T-tau protein levels in plasma on the Simoa HD-1 platform.

The study researchers used linear models with mixed effects adjusted for age, gender, and education to determine the associations between baseline NfL or T-tau plasma NfL or T-tau and cognitive imaging results evaluate. They repeated their analyzes in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) with 387 patients without a diagnosis of dementia and for a median of 3.0 years.

Among the 995 analyzed patients, there was a stronger association between the NfL values ​​of the baseline plasma value and the results of the cognitive and imaging tests compared to the T-tau scores. If both NfL and T-tau levels were elevated at the start of the study, the researchers identified a pronounced cross-sectional correlation with poorer global cognition and memory, as well as with imaging measures (thickness of the temporal cortex, increased number of infarcts) . T-tau did not add to the diagnostic value of NfL. The results using ADNI were similar.

The study’s researchers concluded that “plasma NfL is better suited as a prognostic marker for cognitive decline and imaging changes” than plasma T-tau. However, plasma T-Tau can contribute to a “cross-sectional value for NfL” in certain contexts.

Marks J., Syrjanen J., Graff-Radford J., et al. Comparison of Neurofilament Light and Total Tau as Blood-Based Biomarkers of Neurodegeneration: Associations with Cognitive and Imaging Outcomes Presented at: American Academy of Neurology Annual Virtual Meeting 2021; April 17-22, 2021.

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