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This study introduces age-dependent z scores for neurofilament light (NfL) and an Age- and eGFR-Adjusted NfL Index (AGI) to improve accuracy in neurological disease diagnosis. These tools help interpret NfL levels by accounting for age and kidney function.

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Area of Science:

  • Biomarker Discovery
  • Neuroscience
  • Clinical Chemistry

Background:

  • Neurofilament light (NfL) is a sensitive biomarker for neuroaxonal damage in various neurological conditions.
  • Clinical interpretation of NfL is limited by age and renal function (eGFR).

Purpose of the Study:

  • Establish age-dependent z scores for plasma NfL.
  • Evaluate the impact of eGFR on NfL concentrations.
  • Enhance the interpretative accuracy of NfL biomarkers.

Main Methods:

  • Measured plasma NfL in 133 healthy adults (18-90 years) on the Siemens Atellica® platform.
  • Estimated eGFR using CKD-EPI and BIS1 equations.
  • Developed and validated the Age- and eGFR-Adjusted NfL Index (AGI).

Main Results:

  • NfL showed positive correlation with age (r=0.83) and negative correlation with eGFR (r=-0.78).
  • The AGI index linearly correlated with NfL (r=0.87), predicting reference values.
  • Age-stratified z scores demonstrated high concordance with eGFR-adjusted intervals (r=0.96).

Conclusions:

  • Provides the first age-dependent NfL z scores for the Siemens Atellica platform.
  • The AGI index allows individualized NfL reference intervals.
  • Supports broader clinical application of NfL by accounting for age and eGFR.