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Title: | Cerebrospinal fluid neurofilament light chain differentiates primary psychiatric disorders from rapidly progressive, Alzheimer's disease and frontotemporal disorders in clinical settings. | Austin Authors: | Eratne, Dhamidhu;Loi, Samantha M;Li, Qiao-Xin;Stehmann, Christiane;Malpas, Charles B;Santillo, Alexander;Janelidze, Shorena;Cadwallader, Claire;Walia, Nirbaanjot;Ney, Blair;Lewis, Victoria;Senesi, Matteo;Fowler, Christopher;McGlade, Amelia;Varghese, Shiji;Ravanfar, Parsa;Kelso, Wendy;Farrand, Sarah;Keem, Michael;Kang, Matthew;Goh, Anita M Y;Dhiman, Kunal;Gupta, Veer;Watson, Rosie;Yassi, Nawaf;Kaylor-Hughes, Cath;Kanaan, Richard A A ;Perucca, Piero ;Dobson, Hannah;Vivash, Lucy;Ali, Rashida;O'Brien, Terence J;Hansson, Oskar;Zetterberg, Henrik;Blennow, Kaj;Walterfang, Mark;Masters, Colin L ;Berkovic, Samuel F ;Collins, Steven;Velakoulis, Dennis | Affiliation: | Comprehensive Epilepsy Program Medicine (University of Melbourne) Departments of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.. UK Dementia Research Institute at UCL, London, UK.. Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.. Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.. Department of Psychiatry, Alfred Health, Melbourne, Victoria, Australia.. National Dementia Diagnostics Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.. School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.. School of Medicine, Deakin University, Geelong, Victoria, Australia.. St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.. Department of Psychiatry & Melbourne Neuropsychiatry Centre, University of Melbourne, Parkville, Victoria, Australia.. Department of Neuroscience, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Victoria, Australia.. Psychiatry (University of Melbourne) Department of General Practice, Integrated Mental Health Team, University of Melbourne, Parkville, Victoria, Australia.. Population Health and Immunity Division, the Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.. The Florey Institute of Neuroscience and Mental Health Australian National Creutzfeldt-Jakob Disease Registry, Florey Institute of Neuroscience and Mental Health and Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia.. Neuropsychiatry, Royal Melbourne Hospital, Parkville, Victoria, Australia.. Department of Medicine, Department of Neurology, Clinical Outcomes Research Unit (CORe), Royal Melbourne Hospital, Parkville, Victoria, Australia.. Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden.. Memory Clinic, Skåne University Hospital, Malmo, Sweden.. Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.. |
Issue Date: | 1-Feb-2022 | Date: | 2022 | Publication information: | Alzheimer's & Dementia: the Journal of the Alzheimer's Association 2022 ,18(11) | Abstract: | Many patients with cognitive and neuropsychiatric symptoms face diagnostic delay and misdiagnosis. We investigated whether cerebrospinal fluid (CSF) neurofilament light (NfL) and total-tau (t-tau) could assist in the clinical scenario of differentiating neurodegenerative (ND) from psychiatric disorders (PSY), and rapidly progressive disorders. Biomarkers were examined in patients from specialist services (ND and PSY) and a national Creutzfeldt-Jakob registry (Creutzfeldt-Jakob disease [CJD] and rapidly progressive dementias/atypically rapid variants of common ND, RapidND). A total of 498 participants were included: 197 ND, 67 PSY, 161 CJD, 48 RapidND, and 20 controls. NfL was elevated in ND compared to PSY and controls, with highest levels in CJD and RapidND. NfL distinguished ND from PSY with 95%/78% positive/negative predictive value, 92%/87% sensitivity/specificity, 91% accuracy. NfL outperformed t-tau in most real-life clinical diagnostic dilemma scenarios, except distinguishing CJD from RapidND. We demonstrated strong generalizable evidence for the diagnostic utility of CSF NfL in differentiating ND from psychiatric disorders, with high accuracy. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/28762 | DOI: | 10.1002/alz.12549 | ORCID: | https://orcid.org/0000-0002-3226-7645 https://orcid.org/0000-0002-4953-4500 https://orcid.org/0000-0001-8438-3763 https://orcid.org/0000-0001-8282-9151 https://orcid.org/0000-0003-4026-4863 https://orcid.org/0000-0003-2936-6308 https://orcid.org/0000-0002-3968-2075 https://orcid.org/0000-0003-1397-0359 https://orcid.org/0000-0002-1389-3691 https://orcid.org/0000-0003-3072-7940 https://orcid.org/0000-0003-4580-841X https://orcid.org/0000-0002-5245-6611 https://orcid.org/0000-0003-0992-1917 https://orcid.org/0000-0002-7855-7066 |
Journal: | Alzheimer's & Dementia : The Journal of the Alzheimer's Association | PubMed URL: | 35102694 | PubMed URL: | https://pubmed.ncbi.nlm.nih.gov/35102694/ | Type: | Journal Article | Subjects: | biomarker dementia diagnosis neurofilament neurology psychiatric disorders psychiatry |
Appears in Collections: | Journal articles |
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