Comparison of neurofilament light and heavy chain in spinal muscular atrophy and amyotrophic lateral sclerosis: A pilot study.

Comparison of neurofilament light and heavy chain in spinal muscular atrophy and amyotrophic lateral sclerosis: A pilot study.
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DOI:
10.1002/brb3.2997
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发表时间:
2023-05
期刊:
影响因子:
3.1
通讯作者:
Cui, Li-Ying
Cui, Li-Ying
中科院分区:
心理学4区
文献类型:
--
作者:
Li, Jin-Yue;Dai, Yi;Sun, Xiao-Han;Ren, Hai-tao;Shen, Dong-chao;Yang, Xun-Zhe;Liu, Ming-Sheng;Cui, Li-Ying

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脊髓性肌萎缩症(SMA)和肌萎缩侧索硬化症(ALS)是两种主要的运动神经元疾病,症状相似,但预后较差。本研究旨在确定成年 SMA 患者与散发性 ALS 患者疾病监测和鉴别诊断中的潜在生物标志物。这是一项试点研究,在住院期间连续招募了 10 名成年 SMA 患者和 10 名 ALS 患者。收集血清和脑脊液(CSF)样本以评估神经丝轻链(NFL)和磷酸化神经丝重链(pNFH)。还比较了各组之间的血清肌酸激酶(CK)和肌酐(Cr)。受试者工作特征 (ROC) 曲线用于识别 ALS 和 SMA 患者之间的差异值。 ALS 患者的血清 Cr、CSF NFL 和 CSF pNFH 水平显着高于成人 SMA 患者 (p < .01)。 SMA 患者的血清 CK 和 Cr 与基线 ALSFRS-R 评分密切相关 (p < .001)。 ROC 曲线显示血清 Cr 的曲线下面积 (AUC) 为 0.94,截止值为 44.5 μmol/L(敏感性 90%,特异性 90%)。 CSF NFL 和 CSF pNFH 的 ROC 曲线的 AUC 分别为 1.0 和 0.84,截止值分别为 1275 pg/mL 和 0.395 ng/mL(CSF NFL 的敏感性和特异性分别为 100% 和 100%;CSF pNFH 的敏感性和特异性分别为 90% 和 80%)。 CSF NFL 和 pNFH 可能是成人 SMA 和 ALS 鉴别诊断的有用生物标志物。脊髓性肌萎缩症(SMA)和肌萎缩侧索硬化症(ALS)是两种不同的运动神经元疾病,具有相似的进行性症状和严重残疾。脑脊液中的神经丝轻链 (NFL) 和磷酸化神经丝重链 (pNFH) 可能是鉴别诊断 SMA 和 ALS 的有用生物标志物。
Spinal muscular atrophy (SMA) and amyotrophic lateral sclerosis (ALS) were two major motor neuron diseases with similar symptoms and poor outcomes. This study aimed to identify potential biomarkers in disease monitoring and differential diagnosis of adult SMA patients with sporadic ALS patients. This was a pilot study with ten adult SMA patients and ten ALS patients consecutively enrolled during hospitalization. Serum and cerebrospinal fluid (CSF) samples were collected for assessment of neurofilament light (NFL) and phosphorylated neurofilament heavy chain (pNFH). Serum creatine kinase (CK) and creatinine (Cr) were also compared between groups. The receiver operating characteristic (ROC) curves were used to identify differentiated values among ALS and SMA patients. Serum Cr, CSF NFL, and CSF pNFH levels of ALS patients were significantly higher than those of the adult SMA patients (p < .01). Serum CK and Cr were strongly correlated with baseline ALSFRS‐R scores in SMA patients (p < .001). The ROC curves revealed an area under the curve (AUC) of 0.94 in serum Cr with a cut‐off value of 44.5 μmol/L (Sensitivity 90%, Specificity 90%). AUC from the ROC curve of CSF NFL and CSF pNFH were 1.0 and 0.84, with cut‐off values of 1275 pg/mL and 0.395 ng/mL, respectively (Sensitivity and Specificity of 100% and 100% in CSF NFL; Sensitivity and Specificity of 90% and 80% in CSF pNFH). CSF NFL and pNFH might be useful biomarkers for differential diagnosis of adult SMA and ALS. Spinal muscular atrophy (SMA) and amyotrophic lateral sclerosis (ALS) are two distinct motoneuron diseases with similar progressive symptoms and severe disability. Neurofilament light (NFL) and phosphorylated neurofilament heavy chain (pNFH) in cerebrospinal fluid might be useful biomarkers for differential diagnosis of SMA and ALS.
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