Could a New Blood Test Help Identify Parkinson Disease?

Quantification of blood neurofilament light chain (NfL) protein concentration can be used to distinguish Parkinson disease (PD) from atypical parkinsonian disorders (APD), according to a new study.

The differential diagnosis between PD and APD, such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration, is often difficult due to the overlapping symptomatology, especially during the early stages of the disease course, the researchers explained.
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The study included 3 independent prospective cohorts: the Lund (n=278) and London (n=117) cohorts, comprising healthy controls and patients with PD, PSP, corticobasal syndrome (CBS), and MSA, as well as an early disease cohort (n=109) of patients with PD, PSP, MSA, or CBS with disease duration ≤3 years. They measured blood NfL concentration using an ultrasensitive single molecule array (Simoa) method and investigated the diagnostic accuracy to distinguish PD from APD.

The researchers found strong correlations between blood and CSF concentrations of NfL. They found blood NfL to be increased in patients with MSA, PSP, and CBS when compared to patients with PD as well as healthy controls in all cohorts. Furthermore, in the Lund cohort, blood NfL could accurately distinguish PD from APD with similar results in both the London cohort and the early disease cohort.

“The present study has shown in 3 independent cohorts that NfL concentrations in blood are increased in PSP, MSA, and CBS when compared to PD and healthy controls,” the investigators concluded. “This easily accessible biomarker of axonal degeneration may improve the diagnostic workup of patients with parkinsonian symptoms in specialized clinics as well as in primary care settings.”

—Mike Bederka

Reference:

Hansson O, Janelidze S, Hall S, et al. Blood-based NfL: A biomarker for differential diagnosis of parkinsonian disorder [published online Febuary 8, 2017]. Neurology. doi: http://dx.doi.org/10.1212/WNL.0000000000003680.