Cerebrospinal fluid neurofilament light concentration predic
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This study assessed the utility of cerebrospinal fluid (CSF) neurofilament light (NfL) in Alzheimer's disease (AD) diagnosis, its association with amyloid and pathology, as well as its potential to predict brain atrophy, cognition, and amyloid accumulation.

CSF NfL concentration was measured in 221 participants from the Australian Imaging, Biomarkers & Lifestyle Flagship Study of Ageing (AIBL).

CSF NfL levels as well as NfL/amyloid beta(A beta 42) were significantly elevated in AD compared to healthy controls, and in mild cognitive impairment (MCI) compared to HC. CSF NfL and NfL/A beta42 differentiated AD from HC with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.84 and 0.90, respectively. CSF NfL and NfL/A beta42 predicted cortical amyloid load, brain atrophy, and cognition.

CSF NfL is a biomarker of neurodegeneration, correlating with cognitive impairment and brain neuropathology. It is of similar sensitivity to CSF A beta 42 and tau biomarkers. However, CSF NfL should be used in combination with these more disease specific biomarkers, as it is a general biomarker of neurodegeneration and not specific to any particular neurodegenerative disease. NfL predicts cortical gray matter volume loss, as well as cognitive impairment. Therefore, NfL can be used as a marker of neurodegeneration that associates with cognitive impairment and brain atrophy, along the disease trajectory. It could serve as a better predictor of disease progression.

Recent studies suggest that plasma NfL levels are of diagnostic value in AD. However, blood NfL is thought to originate from the CSF, and blood levels of NfL correlate well with levels seen in the CSF, although they rise to a lesser extent and later than in the CSF. These studies are encouraging; however, studies are still needed to evaluate the diagnostic value of both blood and CSF levels of NfL in preclinical sporadic AD cases.

Source: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/dad2.12005
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