A cohort study revealed that blood neurofilament light chain (NfL) changes predict disease progression and brain neurodegeneration more than a decade before the onset of familial Alzheimer’s disease (AD). The study included 243 participants with an early-onset genetic variant known to cause dominantly inherited AD and 162 unaffected relatives as controls and demonstrated that NfL levels in the cerebrospinal fluid (n = 187) and serum (n = 405) were correlated with one another and were elevated at the presymptomatic stages of familial AD. Longitudinal, within-person analysis of serum NfL dynamics (n = 196) confirmed this elevation and further revealed that the rate of change of serum NfL could discriminate mutation carriers from non-mutation carriers almost a decade earlier than cross-sectional absolute NfL levels (that is, 16.2 versus 6.8 years before the estimated symptom onset). Serum NfL rate of change peaked in participants converting from the presymptomatic to the symptomatic stage and was associated with cortical thinning assessed by magnetic resonance imaging, but less so with amyloid-β deposition or glucose metabolism (currently measured for AD). Serum NfL was predictive for both the rate of cortical thinning and cognitive changes assessed by the Mini–Mental State Examination and Logical Memory test. These findings add to a growing body of evidence suggesting NfL might be used clinically as a blood biomarker for AD and other neurodegenerative diseases and injuries. Source: https://www.nature.com/N
