不同类型痴呆症中的血液神经丝轻链。

Blood Neurofilament Light Chain in Different Types of Dementia.

机构信息

Department of Neurology, Tianjin Huanhu Hospital, 300222, Tianjin, China.

Department of Neurology, the Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, 210031, Jiangsu, China.

出版信息

Curr Alzheimer Res. 2023;20(3):149-160. doi: 10.2174/1567205020666230601123123.

DOI:10.2174/1567205020666230601123123

PMID:37264656

Abstract

AIMS

The study aimed to evaluate diagnostic values of circulating neurofilament light chain (NFL) levels in different types of dementia.

BACKGROUND

Previous studies reported inconsistent change of blood NFL for different types of dementia, including Alzheimer's disease (AD), frontotemporal dementia (FTD), Parkinson's disease dementia (PDD) and Creutzfeldt-Jakob disease (CJD) and Lewy body dementia (LBD).

OBJECTIVE

Meta-analysis was conducted to summarize the results of studies evaluating diagnostic values of circulating NFL levels in different types of dementia to enhance the strength of evidence.

METHODS

Articles evaluating change in blood NFL levels in dementia and published before July 2022 were searched on the following databases (PubMed, Web of Science, EMBASE, Medline and Google Scholar). The computed results were obtained by using STATA 12.0 software.

RESULTS

AD patients showed increased NFL concentrations in serum and plasma, compared to healthy controls (HC) (standard mean difference (SMD) = 1.09, 95% confidence interval (CI): 0.48, 1.70, I = 97.4%, < 0.001). In AD patients, higher NFL concentrations in serum and plasma were associated with reduced cerebrospinal fluid (CSF) Aβ, increased CSF t-tau, increased CSF p-tau, reduced Mini-Mental State Examination (MMSE) and decreased memory. Additionally, mild cognitive impairment (MCI) showed elevated NFL concentrations in serum and plasma, compared to HC (SMD = 0.53, 95% CI: 0.18, 0.87, I = 93.8%, < 0.001). However, in MCI, no significant association was found between NFL concentrations in serum, plasma and memory or visuospatial function. No significant difference was found between preclinical AD and HC (SMD = 0.18, 95% CI: -0.10, 0.47, I = 0.0%, = 0.438). FTD patients showed increased NFL concentrations in serum and plasma, compared to HC (SMD = 1.08, 95% CI: 0.72, 1.43, I = 83.3%, < 0.001). Higher NFL concentrations in serum and plasma were associated with increased CSF NFL in FTD. Additionally, the pooled parameters calculated were as follows: sensitivity, 0.82 (95% CI: 0.72, 0.90); specificity, 0.91 (95% CI: 0.83, 0.96). CJD patients showed increased NFL concentrations in serum and plasma, compared to HC. No significant difference in NFL level in serum and plasma was shown between AD and FTD (SMD = -0.03, 95% CI: -0.77, 0.72, I = 83.3%, = 0.003).

CONCLUSION

In conclusion, the study suggested abnormal blood NFL level in AD and MCI, but not in preclinical AD. FTD and CJD showed abnormal blood NFL levels.

摘要

目的

本研究旨在评估循环神经丝轻链（NFL）水平在不同类型痴呆中的诊断价值。

背景

先前的研究报告称，不同类型的痴呆（包括阿尔茨海默病（AD）、额颞叶痴呆（FTD）、帕金森病痴呆（PDD）和克雅氏病（CJD）和路易体痴呆（LBD））的血液 NFL 变化不一致。

目的

进行荟萃分析以总结评估不同类型痴呆症中循环 NFL 水平诊断价值的研究结果，以增强证据强度。

方法

在以下数据库中搜索评估痴呆症中血液 NFL 水平变化并在 2022 年 7 月之前发表的文章（PubMed、Web of Science、EMBASE、Medline 和 Google Scholar）。使用 STATA 12.0 软件计算计算结果。

结果

与健康对照组（HC）相比，AD 患者的血清和血浆中 NFL 浓度升高（标准均数差（SMD）= 1.09，95%置信区间（CI）：0.48，1.70，I = 97.4%，< 0.001）。在 AD 患者中，血清和血浆中更高的 NFL 浓度与脑脊液（CSF）Aβ减少、CSF t-tau 增加、CSF p-tau 增加、简易精神状态检查（MMSE）降低和记忆力下降有关。此外，与 HC 相比，轻度认知障碍（MCI）的血清和血浆中 NFL 浓度升高（SMD = 0.53，95%CI：0.18，0.87，I = 93.8%，< 0.001）。然而，在 MCI 中，血清和血浆中 NFL 浓度与记忆或视觉空间功能之间没有显著相关性。AD 前期和 HC 之间未发现血清中 NFL 浓度有显著差异（SMD = 0.18，95%CI：-0.10，0.47，I = 0.0%，= 0.438）。与 HC 相比，FTD 患者的血清和血浆中 NFL 浓度升高（SMD = 1.08，95%CI：0.72，1.43，I = 83.3%，< 0.001）。血清和血浆中更高的 NFL 浓度与 FTD 中的 CSF NFL 增加有关。此外，计算出的汇总参数如下：敏感性，0.82（95%CI：0.72，0.90）；特异性，0.91（95%CI：0.83，0.96）。与 HC 相比，CJD 患者的血清和血浆中 NFL 浓度升高。AD 和 FTD 之间血清和血浆中 NFL 水平无显著差异（SMD = -0.03，95%CI：-0.77，0.72，I = 83.3%，= 0.003）。