Serum Neurofilament Light Chain Level as an Indicator of Axonal Injury in Parsonage–Turner Syndrome (Neuralgic Amyotrophy)

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Peripheral Nervous System Pub Date : 2025-09-29 DOI:10.1111/jns.70063

Sophie C. Queler, Ek Tsoon Tan, Ari Green, Carlo Milani, Ahmed Abdelhak, Darryl B. Sneag

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Abstract

Background and Aims

Parsonage–Turner syndrome (PTS), also known as neuralgic amyotrophy, is a peripheral neuropathy resulting in severe axonal loss. This study aimed to characterize initial elevation and longitudinal trends of serum neurofilament light chain (sNfL), a marker of neuro-axonal damage, in PTS.

Methods

This prospective cohort included 29 adults with electromyography (EMG)–confirmed PTS ≤ 6 months from symptom onset. Patients underwent sNfL testing and EMG at baseline (median 86 days from symptom onset) and again at 3- and 6-month follow-up intervals. Age- and BMI-adjusted Z-scores were analyzed. Linear mixed-effects models assessed associations between sNfL and time from onset, number of nerves involved, EMG metrics, and corticosteroid use.

Results

Mean sNfL Z-scores were significantly elevated (1.64, SD 1.32, p < 0.001) compared with healthy controls at 0 (1.64, p < 0.001) and 3 months (0.49, SD 1.06, p = 0.020). At 6 months, statistically significant elevations were not detected (0.39, SD 0.96, p = 0.106). sNfL declined by 0.17 Z-scores per month (95% CI: 0.11–0.23; p < 0.001). On EMG, the presence of nascent motor units, reflecting reinnervation, was associated with lower sNfL (p = 0.043).

Interpretation

sNfL elevation was detected in PTS patients within the first 6 months from symptom onset and decreased as reinnervation ensued. These findings suggest sNfL deserves further consideration as a blood-based biomarker for detection and monitoring of PTS.

Abstract Image

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血清神经丝轻链水平作为帕森纳-特纳综合征（神经性肌萎缩症）轴突损伤的指标。

背景和目的：帕森纳-特纳综合征（PTS），也称为神经痛性肌萎缩症，是一种导致严重轴突丧失的周围神经病变。本研究旨在描述PTS患者血清神经丝轻链（sNfL）的初始升高和纵向趋势，sNfL是神经轴突损伤的标志。方法：该前瞻性队列包括29名肌电图（EMG）证实PTS的成人，症状发作≤6个月。患者在基线时（症状出现后中位86天）接受sNfL检测和肌电图检查，并在3个月和6个月的随访间隔中再次接受检查。分析年龄和bmi调整后的z分数。线性混合效应模型评估了sNfL与发病时间、受累神经数量、肌电图指标和皮质类固醇使用之间的关系。结果：平均sNfL z评分显著升高（1.64，标准差1.32,p）。解释：PTS患者在症状出现后的前6个月内检测到sNfL升高，并随着神经重建而降低。这些发现表明sNfL值得进一步考虑作为检测和监测PTS的血液生物标志物。

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 Peripheral Nervous System 医学-临床神经学

CiteScore

6.10

自引率

7.90%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.