Baiardi Simone, Rossi Marcello, Giannini Giulia, Mammana Angela, Polischi Barbara, Sambati Luisa, Mastrangelo Andrea, Magliocchetti Franco, Cortelli Pietro, Capellari Sabina, Calandra Buonaura Giovanna, Parchi Piero
Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy.
IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
NPJ Parkinsons Dis. 2025 Apr 28;11(1):98. doi: 10.1038/s41531-025-00951-y.
Neurofilament light chain protein (NfL) is a valuable biomarker for the differential diagnosis between Parkinson's disease (PD) and atypical parkinsonian disorders (APD). Here, we compared the performance of four cerebrospinal fluid (CSF) and three plasma NfL immunoassays in 253 PD and 265 APD. We measured NfL by ELISA in CSF and by SiMoA, CLEIA, and ELLA in both CSF and plasma. Additionally, we assessed Lewy body pathology by CSF α-synuclein real-time quaking-induced conversion assay (α-syn-RT-QuIC). In each biofluid, the tested assays showed comparable precision; however, CSF NfL showed higher diagnostic accuracy than plasma NfL for discriminating PD from APD (AUC range 0.966-0.974 vs 0.917-0.924). Combining CSF NfL and α-syn-RT-QuIC increased diagnostic accuracy. These results confirm the high diagnostic value of NfL in patients with parkinsonism, even when different assays are used. Combining CSF NfL and α-syn-RT-QuIC provides the highest accuracy, followed by CSF NfL and plasma NfL.
神经丝轻链蛋白（NfL）是用于帕金森病（PD）和非典型帕金森综合征（APD）鉴别诊断的一种有价值的生物标志物。在此，我们比较了4种脑脊液（CSF）和3种血浆NfL免疫测定法在253例PD患者和265例APD患者中的表现。我们通过酶联免疫吸附测定（ELISA）检测脑脊液中的NfL，并通过单分子阵列（SiMoA）、化学发光酶免疫分析（CLEIA）和电化学发光免疫分析（ELLA）检测脑脊液和血浆中的NfL。此外，我们通过脑脊液α-突触核蛋白实时震颤诱导转化试验（α-syn-RT-QuIC）评估路易体病理。在每种生物流体中，所测试的测定法显示出相当的精密度；然而，在区分PD和APD方面，脑脊液NfL比血浆NfL具有更高的诊断准确性（曲线下面积范围为0.966 - 0.974对0.917 - 0.924）。联合脑脊液NfL和α-syn-RT-QuIC可提高诊断准确性。这些结果证实了NfL在帕金森综合征患者中的高诊断价值，即使使用不同的测定法。联合脑脊液NfL和α-syn-RT-QuIC可提供最高的准确性，其次是脑脊液NfL和血浆NfL。
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