Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Diagnostic Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Dement Geriatr Cogn Disord. 2020;49(4):401-409. doi: 10.1159/000510325. Epub 2020 Nov 26.
A previously published paper (referred to as the original cohort) showed that using a cutoff value of 116.1 fg/mL for the plasma total α-synuclein concentrations could discriminate Parkinson's disease (PD) patients from normal controls (NCs). In this study, another independent cohort (referred to as the validation cohort) was recruited to validate the agreement between the clinical diagnosis and the use of plasma total α-synuclein to identify PD patients. In addition to total α-synuclein, plasma neurofilament light chain (NfL) in the validation cohort was detected.
Seventy PD patients and 33 NCs were enrolled in the validation cohort. A clinical diagnosis and the immunomagnetic reduction (IMR) assay for plasma total α-synuclein were performed for each participant. Thirty-three of 70 PD patients and 23 of 33 NCs were subjected to the plasma NfL assay via IMR.
The positive, negative, and overall percentages of agreement between the clinical diagnosis and plasma total α-synuclein diagnosis determined based on 116.1 fg/mL as the cutoff value were found to be 0.943, 0.818, and 0.903, respectively. The PD patients and NCs showed plasma NfL levels of 8.38 ± 4.19 pg/mL and 17.6 ± 7.95 pg/mL (p < 0.001), respectively. The cutoff value of the plasma NfL level used to differentiate PD patients from NCs was 12.8 pg/mL, with sensitivity and specificity values of 0.788 and 0.870, respectively.
The results demonstrate the usefulness of the plasma total α-synuclein concentration to discriminate PD patients from NCs and reveal the elevation of the plasma NfL level in PD patients.
先前发表的一篇论文（简称原始队列）表明，使用血浆总α-突触核蛋白浓度的截断值 116.1 fg/mL 可以区分帕金森病（PD）患者和正常对照（NCs）。在这项研究中，招募了另一个独立的队列（称为验证队列）来验证临床诊断与使用血浆总α-突触核蛋白识别 PD 患者之间的一致性。除了总α-突触核蛋白外，还检测了验证队列中的血浆神经丝轻链（NfL）。
验证队列纳入了 70 名 PD 患者和 33 名 NCs。对每个参与者进行临床诊断和血浆总α-突触核蛋白的免疫磁还原（IMR）检测。对 70 名 PD 患者中的 33 名和 33 名 NCs 中的 23 名进行了通过 IMR 的血浆 NfL 检测。
基于 116.1 fg/mL 作为截断值，临床诊断与血浆总α-突触核蛋白诊断之间的阳性、阴性和总体一致性百分比分别为 0.943、0.818 和 0.903。PD 患者和 NCs 的血浆 NfL 水平分别为 8.38±4.19 pg/mL 和 17.6±7.95 pg/mL（p<0.001）。用于区分 PD 患者和 NCs 的血浆 NfL 水平截断值为 12.8 pg/mL，其灵敏度和特异性分别为 0.788 和 0.870。
结果表明血浆总α-突触核蛋白浓度可用于区分 PD 患者和 NCs，并揭示了 PD 患者血浆 NfL 水平升高。
