CSF neurofilament light chain reflects corticospinal tract degeneration in ALS.
CSF neurofilament light chain reflects corticospinal tract degeneration in ALS.
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DOI：
10.1002/acn3.212
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发表时间：
2015-07
影响因子：
5.3
通讯作者：
Turner MR
中科院分区：
文献类型：
--
作者：
Menke RA;Gray E;Lu CH;Kuhle J;Talbot K;Malaspina A;Turner MR
扩散张量成像（DTI）对白色束病变敏感。在肌萎缩侧索硬化症（ALS）中已经确定了涉及皮质脊髓束（CST）的核心特征。脑脊液（CSF）中升高的神经丝轻链蛋白（NfL）被认为反映了一系列神经系统疾病中的轴突损伤。探讨了这两种措施之间的关系。从ALS患者（n = 25 CSF，40血清）和健康的、年龄相似的对照（n = 17 CSF，25血清）获得CSF和血清NfL浓度以及在同一天在3特斯拉下获得的DTI。组内相关性NfL和DTI措施的显微结构完整性的主要白色物质束（CST，上级纵束[SLF]，胼胝体）进行了基于束的空间统计。与对照组相比，患者的NfL水平更高。CSF水平与临床上运动神经元负荷和疾病进展率相关。在ALS患者的CST中，较高的NfL水平与较低的DTI各向异性分数和增加的径向扩散率显著相关，但在对照组中则不然。CSF和血清NfL升高部分是ALS中CST变性的结果。这突出了在神经系统疾病中结合神经化学和基于神经成像的生物标志物的更广泛潜力。
Diffusion tensor imaging (DTI) is sensitive to white matter tract pathology. A core signature involving the corticospinal tracts (CSTs) has been identified in amyotrophic lateral sclerosis (ALS). Raised neurofilament light chain protein (NfL) in cerebrospinal fluid (CSF) is thought to reflect axonal damage in a range of neurological disorders. The relationship between these two measures was explored. CSF and serum NfL concentrations and DTI acquired at 3 Tesla on the same day were obtained from ALS patients (n = 25 CSF, 40 serum) and healthy, age-similar controls (n = 17 CSF, 25 serum). Within-group correlations between NfL and DTI measures of microstructural integrity in major white matter tracts (CSTs, superior longitudinal fasciculi [SLF], and corpus callosum) were performed using tract-based spatial statistics. NfL levels were higher in patients compared to controls. CSF levels correlated with clinical upper motor neuron burden and rate of disease progression. Higher NfL levels were significantly associated with lower DTI fractional anisotropy and increased radial diffusivity in the CSTs of ALS patients, but not in controls. Elevated CSF and serum NfL is, in part, a result of CST degeneration in ALS. This highlights the wider potential for combining neurochemical and neuroimaging-based biomarkers in neurological disease.