Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/28762
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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