Phosphorylated neurofilament heavy chain levels in paired plasma and CSF of amyotrophic lateral sclerosis

Abstract

Background and objectiveAmyotrophic lateral sclerosis (ALS) is a fatal disease characterized by degeneration of both upper and lower motor neurons. In this study, we aimed to measure both plasma and cerebrospinal fluid (CSF) phosphorylated neurofilament heavy chain (pNF-H) levels in patients with ALS, and determine if there is a correlation. We also evaluated plasma and CSF pNF-H levels to investigate if this biomarker could predict the time to generalization (TTG) in ALS better. MethodsPaired plasma and CSF pNF-H levels of patients with ALS (n=51), multiple system atrophy (n=12) and controls (n=30) were measured by monoclonal sandwich ELISA. TTG, which also indicates the time of symptoms spreading from spinal or bulbar localization to both, was evaluated in all ALS patients. ResultsWe found a strong correlation between plasma and CSF pNF-H levels within individual patients (r=0.712, p<0.001). The mean TTG in ALS patients was 22.9months (range 1–84months), and there was an inverse correlation between plasma (r=−0.661; p<0.001)/CSF (r=−0.869; p<0.001) pNF-H levels and TTG. ConclusionThe correlation of plasma and CSF pNF-H levels would bring insight into the pathogenesis of ALS. TTG might play an important role in the future study of ALS, as an early indicator of survival.