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Neurofilament Light Chain in Serum and CSF as a Potential Biomarker for Primary Angiitis of the Central Nervous
Christina Krüger1, Hans Pinnschmidt2, Maximilian Wilmes1
1Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Background:
Primary angiitis of the central nervous system (PACNS) is a rare vasculitis affecting CNS blood vessels, posing diagnostic challenges due to the limited specificity of the established diagnostic tools. Neurofilament light chain (NfL) might be a promising biomarker in PACNS.
Methods:
NfL in serum and CSF was measured in 33 PACNS patients (25 active [aPACNS], 8 in remission [rPACNS]) enrolled between 2014 and 2022 and compared to controls (serum: n = 303; CSF: n = 68); Results: Serum NfL was significantly elevated in aPACNS (median: 45.77 pg/mL) versus rPACNS (6.68 pg/mL; p < 0.001) and healthy controls (6.05 pg/mL; p < 0.001). Similarly, CSF NfL was significantly elevated in aPACNS (median: 4914.58 pg/mL) compared to rPACNS (301.19 pg/mL; p = 0.002) and controls (262.83 pg/mL; p < 0.001). Serum and CSF NfL were significantly correlated (r = 0.90, p < 0.001). Additionally, an association between elevated NfL and ischemic lesions was observed (serum: r = 0.59, p = 0.006; CSF: r = 0.43, p = 0.032). A subgroup analysis excluding stroke patients still revealed elevated NfL in 90% (CSF) and 50% (serum), with diminishing discriminatory power with older age.
Conclusions:
NfL holds potential as a biomarker for PACNS, in particular in younger patients.
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