CSF neurofilament light chain and tau differentiate multiple system atrophy from Parkinson's disease

Abdo, W. Farid; Bloem, Bastiaan R.; Van Geel, Wieneke J.; Esselink, Rianne A.J.; Verbeek, Marcel M.

doi:10.1016/j.neurobiolaging.2006.03.010

« Previous Next »Neurobiology of Aging
Volume 28, Issue 5 , Pages 742-747, May 2007

CSF neurofilament light chain and tau differentiate multiple system atrophy from Parkinson's disease

W. Farid Abdo
- Department of Neurology, Radboud University, Nijmegen Medical Centre, The Netherlands
- Corresponding author at: Parkinson Centre Nijmegen (ParC), Department of Neurology (935), Radboud University, Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 24 3615202; fax: +31 243541122.
Bastiaan R. Bloem
- Department of Neurology, Radboud University, Nijmegen Medical Centre, The Netherlands
Wieneke J. Van Geel
- Laboratory of Pediatrics and Neurology, Radboud University, Nijmegen Medical Centre, The Netherlands
Rianne A.J. Esselink
- Department of Neurology, Radboud University, Nijmegen Medical Centre, The Netherlands
- Department of Geriatrics, Radboud University, Nijmegen Medical Centre, The Netherlands
Marcel M. Verbeek
- Department of Neurology, Radboud University, Nijmegen Medical Centre, The Netherlands
- Laboratory of Pediatrics and Neurology, Radboud University, Nijmegen Medical Centre, The Netherlands

Received 19 September 2005; received in revised form 23 January 2006; accepted 21 March 2006. published online 09 May 2006.

Abstract

Background

In early disease stages it can be clinically difficult to differentiate idiopathic Parkinson's disease (IPD) from patients with multiple system atrophy predominated by parkinsonism (MSA-P).

Methods

In CSF of 31 patients with IPD, 19 patients with MSA-P, we analyzed tau, neurofilament light chain (NFL) and heavy chain (NFHp35) and the noradrenergic metabolite 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG).

Results

CSF levels of NFL, NFHp35, and tau were significantly increased in MSA-P (all p<0.0001), whereas, MHPG levels were significantly decreased in MSA-P (p<0.0001). Optimal discriminative cut-off values for the differentiation between MSA-P and IPD were calculated resulting in high sensitivity (76–94%) and specificity (83–97%) levels. Multivariate logistic regression resulted in the combination of NFL and tau as independent contributors in differentiating between MSA-P and IPD.

Discussion

Higher CSF levels of axonal biomarkers could reflect advanced axonal degeneration in MSA-P. Differentiating MSA-P from IPD could be accurately possible with CSF analysis of a combination of axonal and neurotransmitter biomarkers.

Keywords: Multiple system atrophy, Parkinson's disease, Cerebrospinal fluid, Neurofilament, Tau, Diagnostic accuracy