Cerebrospinal fluid neurofilament light chain differentiates primary psychiatric disorders from rapidly progressive, Alzheimer's disease and frontotemporal disorders in clinical settings

被引：27

作者：

Eratne, Dhamidhu ^{[1
,2
,3
,4
]}

Loi, Samantha M. ^{[1
,2
,3
,4
]}

Qiao-Xin Li ^{[4
]}

Stehmann, Christiane ^{[4
,5
,6
]}

Malpas, Charles B. ^{[7
]}

Santillo, Alexander ^{[8
,9
]}

Janelidze, Shorena ^{[8
,9
]}

Cadwallader, Claire ^{[1
]}

Walia, Nirbaanjot ^{[1
]}

Ney, Blair ^{[10
,11
]}

Lewis, Victoria ^{[5
,6
]}

Senesi, Matteo ^{[5
,6
]}

Fowler, Christopher ^{[10
]}

McGlade, Amelia ^{[4
]}

Varghese, Shiji ^{[4
]}

Ravanfar, Parsa ^{[1
,2
,3
]}

Kelso, Wendy ^{[1
]}

Farrand, Sarah ^{[1
,2
,3
]}

Keem, Michael ^{[1
]}

Kang, Matthew ^{[1
]}

Goh, Anita M. Y. ^{[1
,2
,3
]}

Dhiman, Kunal ^{[12
,13
]}

Gupta, Veer ^{[12
,13
]}

Watson, Rosie ^{[14
]}

Yassi, Nawaf ^{[14
,15
,16
]}

Kaylor-Hughes, Cath ^{[17
]}

Kanaan, Richard ^{[18
]}

Perucca, Piero ^{[19
,20
,21
]}

Dobson, Hannah ^{[1
,22
]}

Vivash, Lucy ^{[21
]}

Ali, Rashida ^{[21
]}

O'Brien, Terence J. ^{[21
]}

Hansson, Oskar ^{[8
,9
]}

Zetterberg, Henrik ^{[23
,24
,25
,26
]}

Blennow, Kaj ^{[23
,24
]}

Walterfang, Mark ^{[1
,2
,3
,10
]}

Masters, Colin L. ^{[4
]}

Berkovic, Samuel F. ^{[27
]}

Collins, Steven ^{[5
,6
]}

Velakoulis, Dennis ^{[1
,2
,3
]}

机构：

[1] Royal Melbourne Hosp, Neuropsychiat, 300 Grattan St, Parkville, Vic 3050, Australia

[2] Univ Melbourne, Dept Psychiat, Parkville, Vic, Australia

[3] Univ Melbourne, Melbourne Neuropsychiat Ctr, Parkville, Vic, Australia

[4] Florey Inst Neurosci & Mental Hlth, Natl Dementia Diagnost Lab, Parkville, Vic, Australia

[5] Univ Melbourne, Florey Inst Neurosci & Mental Hlth, Australian Natl Creutzfeldt Jakob Dis Registry, Parkville, Vic, Australia

[6] Univ Melbourne, Dept Med, Parkville, Vic, Australia

[7] Royal Melbourne Hosp, Dept Med, Dept Neurol, Clin Outcomes Res Unit CORe, Parkville, Vic, Australia

[8] Lund Univ, Dept Clin Sci Malmo, Clin Memory Res Unit, Lund, Sweden

[9] Skane Univ Hosp, Memory Clin, Malmo, Sweden

[10] Florey Inst Neurosci & Mental Hlth, Parkville, Vic, Australia

[11] St Vincents Hosp Melbourne, Fitzroy, Vic, Australia

[12] Deakin Univ, Sch Med, Geelong, Vic, Australia

[13] Edith Cowan Univ, Sch Med & Hlth Sci, Joondalup, WA, Australia

[14] Walter & Eliza Hall Inst Med Res, Populat Hlth & Immun Div, Parkville, Vic, Australia

[15] Univ Melbourne, Melbourne Brain Ctr, Dept Med, Royal Melbourne Hosp, Parkville, Vic, Australia

[16] Univ Melbourne, Melbourne Brain Ctr, Dept Neurol, Royal Melbourne Hosp, Parkville, Vic, Australia

[17] Univ Melbourne, Dept Gen Practice, Integrated Mental Hlth Team, Parkville, Vic, Australia

[18] Univ Melbourne, Dept Psychiat, Austin Hlth, Heidelberg, Vic, Australia

[19] Univ Melbourne, Dept Med, Austin Hlth, Heidelberg, Vic, Australia

[20] Univ Melbourne, Austin Hlth, Comprehens Epilepsy Program, Heidelberg, Vic, Australia

[21] Monash Univ, Alfred Hosp, Cent Clin Sch, Dept Neurosci, Melbourne, Vic, Australia

[22] Alfred Hlth, Dept Psychiat, Melbourne, Vic, Australia

[23] Univ Gothenburg, Inst Neurosci & Physiol, Dept Psychiat & Neurochem, Sahlgrenska Acad, Molndal, Sweden

[24] Sahlgrens Univ Hosp, Clin Neurochem Lab, Molndal, Sweden

[25] UCL Inst Neurol, Dept Neurodegenerat Dis, Queen Sq, London, England

[26] UCL, UK Dementia Res Inst, London, England

[27] Univ Melbourne, Epilepsy Res Ctr, Dept Med, Austin Hlth, Heidelberg, Vic, Australia

来源：

ALZHEIMERS & DEMENTIA | 2022年 / 18卷 / 11期

基金：

英国医学研究理事会; 瑞典研究理事会; 澳大利亚国家健康与医学研究理事会;

关键词：

biomarker; dementia; diagnosis; neurofilament; neurology; psychiatric disorders; psychiatry; CREUTZFELDT-JAKOB-DISEASE; NEURODEGENERATIVE DEMENTIA; DIAGNOSTIC-ACCURACY; BIOMARKERS; TAU; CSF; PATHOLOGY; SEVERITY; PROTEIN;

D O I：

10.1002/alz.12549

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Introduction Many patients with cognitive and neuropsychiatric symptoms face diagnostic delay and misdiagnosis. We investigated whether cerebrospinal fluid (CSF) neurofilament light (NfL) and total-tau (t-tau) could assist in the clinical scenario of differentiating neurodegenerative (ND) from psychiatric disorders (PSY), and rapidly progressive disorders. Methods Biomarkers were examined in patients from specialist services (ND and PSY) and a national Creutzfeldt-Jakob registry (Creutzfeldt-Jakob disease [CJD] and rapidly progressive dementias/atypically rapid variants of common ND, RapidND). Results A total of 498 participants were included: 197 ND, 67 PSY, 161 CJD, 48 RapidND, and 20 controls. NfL was elevated in ND compared to PSY and controls, with highest levels in CJD and RapidND. NfL distinguished ND from PSY with 95%/78% positive/negative predictive value, 92%/87% sensitivity/specificity, 91% accuracy. NfL outperformed t-tau in most real-life clinical diagnostic dilemma scenarios, except distinguishing CJD from RapidND. Discussion We demonstrated strong generalizable evidence for the diagnostic utility of CSF NfL in differentiating ND from psychiatric disorders, with high accuracy.

引用

页码：2218 / 2233

页数：16

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