Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
Parkinsonism Relat Disord. 2010 Feb;16(2):142-5. doi: 10.1016/j.parkreldis.2009.07.007. Epub 2009 Jul 31.
Cerebrospinal fluid (CSF) levels of neurofilament light protein (NFL), a marker of neuronal damage, are normal in Parkinson's disease (PD) but elevated in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). Therefore, CSF NFL can help differentiate between PD on one hand and MSA/PSP on the other. In the present study of 10 patients with PD, 21 with MSA, 14 with PSP, 11 with corticobasal degeneration (CBD), and 59 healthy controls, this previous observation is confirmed and also extended to include CBD by showing that similarly high CSF NFL levels are seen not only in MSA and PSP but also in CBD. CSF levels of glial fibrillary acidic protein (GFAP), a protein expressed mainly in fibrillary astrocytes, were similar in all investigated groups. In addition, consecutive analyses of CSF NFL and CSF GFAP levels showed relatively stable levels over time in all the investigated parkinsonian disorders, suggesting that the rate of neuronal degeneration is rather constant over time. Our results suggest that measurements of CSF NFL but not GFAP can be useful in the differential diagnosis of PD versus atypical parkinsonian disorders (APD). However they do not help differentiate between the different APD.
脑脊液（CSF）中的神经丝轻蛋白（NFL）水平，是神经元损伤的标志物，在帕金森病（PD）中正常，但在多系统萎缩（MSA）和进行性核上性麻痹（PSP）中升高。因此，CSF NFL 有助于区分 PD 与 MSA/PSP。在本研究中，纳入了 10 名 PD 患者、21 名 MSA 患者、14 名 PSP 患者、11 名皮质基底节变性（CBD）患者和 59 名健康对照者。该研究证实了之前的观察结果，并扩展至包括 CBD，表明不仅在 MSA 和 PSP 中，而且在 CBD 中也观察到同样高的 CSF NFL 水平。脑脊液中胶质纤维酸性蛋白（GFAP）水平，主要在纤维星形胶质细胞中表达，在所有研究组中相似。此外，对 CSF NFL 和 CSF GFAP 水平的连续分析表明，所有研究的帕金森病中 CSF NFL 和 CSF GFAP 水平随时间相对稳定，提示神经元退化的速度随时间相对恒定。我们的研究结果表明，CSF NFL 而非 GFAP 的测量值可有助于 PD 与非典型帕金森病（APD）的鉴别诊断。但 CSF NFL 并不能帮助区分不同的 APD。
