Plasma neurofilament light outperforms glial fibrillary acidic protein in differentiating behavioural variant frontotemporal dementia from primary psychiatric disorders

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences Pub Date : 2024-11-08 DOI:10.1016/j.jns.2024.123291

Dhamidhu Eratne , Matthew J.Y. Kang , Courtney Lewis , Christa Dang , Charles Malpas , Suyi Ooi , Amy Brodtmann , David Darby , Henrik Zetterberg , Kaj Blennow , Michael Berk , Olivia Dean , Chad Bousman , Naveen Thomas , Ian Everall , Chris Pantelis , Cassandra Wannan , Claudia Cicognola , Oskar Hansson , Shorena Janelidze , Dennis Velakoulis

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引用次数: 0

Abstract

Objective

Timely, accurate distinction between behavioural variant frontotemporal dementia (bvFTD) and primary psychiatric disorders (PPD) is a clinical challenge. Blood biomarkers such as neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have shown promise. Prior work has shown NfL helps distinguish FTD from PPD. Few studies have assessed NfL together with GFAP.

Methods

We investigated plasma GFAP and NfL levels in participants with bvFTD, bipolar affective disorder (BPAD), major depressive disorder (MDD), treatment-resistant schizophrenia (TRS), healthy controls (HC), adjusting for age and sex. We compared ability of GFAP and NfL to distinguish bvFTD from PPD.

Results

Plasma GFAP levels were significantly (all p < 0.001) elevated in bvFTD (n = 22, mean (M) = 273 pg/mL) compared to BPAD (n = 121, M = 96 pg/mL), MDD (n = 42, M = 105 pg/mL), TRS (n = 82, M = 67.9 pg/mL), and HC (n = 120, M = 76.8 pg/mL). GFAP distinguished bvFTD from all PPD with an area under the curve (AUC) of 0.85, 95 % confidence interval [0.76, 0.95]. The optimal cut-off of 105 pg/mL was associated with 73 % specificity and 86 % sensitivity. NfL had AUC 0.95 [0.91, 0.99], 13.3 pg/mL cut-off, 88 % specificity, 86 % sensitivity, and was superior to GFAP (p = 0.02863) and combination of GFAP and NfL (p = 0.04726).

Conclusions

This study found elevated GFAP levels in bvFTD compared to a large cohort of PPD, but NfL levels exhibited better performance in this distinction. These findings extend the literature on GFAP in bvFTD and build evidence for plasma NfL as a useful biomarker to assist with distinguishing bvFTD from PPD. Utilisation of NfL may improve timely and accurate diagnosis of bvFTD.

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血浆神经丝光在区分行为变异型额颞叶痴呆症和原发性精神病方面优于胶质纤维酸性蛋白。

目的：及时、准确地区分行为变异型额颞叶痴呆症（bvFTD）和原发性精神障碍（PPD）是一项临床挑战。神经丝蛋白轻链（NfL）和胶质纤维酸性蛋白（GFAP）等血液生物标志物已显示出良好的前景。先前的研究表明，NfL有助于区分FTD和PPD。很少有研究同时评估 NfL 和 GFAP：我们调查了患有 bvFTD、双相情感障碍（BPAD）、重度抑郁障碍（MDD）、难治性精神分裂症（TRS）和健康对照组（HC）的参与者的血浆 GFAP 和 NfL 水平，并对年龄和性别进行了调整。我们比较了GFAP和NfL区分bvFTD和PPD的能力：结果：血浆 GFAP 水平显著升高（均为 p 结论：血浆 GFAP 和 NfL 水平的升高对 bvFTD 和 PPD 有显著影响：本研究发现，与一大批 PPD 患者相比，bvFTD 患者的 GFAP 水平升高，但 NfL 水平在这种区分中表现出更好的性能。这些发现扩展了有关 bvFTD 中 GFAP 的文献，并为血浆 NfL 作为一种有用的生物标志物提供了证据，有助于区分 bvFTD 和 PPD。利用 NfL 可以提高 bvFTD 诊断的及时性和准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Neurological Sciences 医学-临床神经学

CiteScore

7.60

自引率

2.30%

发文量

313

审稿时长

22 days

期刊介绍： The Journal of the Neurological Sciences provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. JNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials). JNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism.