Head-to-head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in Parkinsonism

Abstract Neurofilament light chain protein (NfL) is a valuable biomarker for the differential diagnosis between Parkinson’s disease (PD) and atypical parkinsonian disorders (APD). Here, we compared the performance of four cerebrospinal fluid (CSF) and three plasma NfL immunoassays in 253 PD and 265...

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Main Authors: Simone Baiardi, Marcello Rossi, Giulia Giannini, Angela Mammana, Barbara Polischi, Luisa Sambati, Andrea Mastrangelo, Franco Magliocchetti, Pietro Cortelli, Sabina Capellari, Giovanna Calandra Buonaura, Piero Parchi
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:npj Parkinson's Disease
Online Access:https://doi.org/10.1038/s41531-025-00951-y
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author Simone Baiardi
Marcello Rossi
Giulia Giannini
Angela Mammana
Barbara Polischi
Luisa Sambati
Andrea Mastrangelo
Franco Magliocchetti
Pietro Cortelli
Sabina Capellari
Giovanna Calandra Buonaura
Piero Parchi
author_facet Simone Baiardi
Marcello Rossi
Giulia Giannini
Angela Mammana
Barbara Polischi
Luisa Sambati
Andrea Mastrangelo
Franco Magliocchetti
Pietro Cortelli
Sabina Capellari
Giovanna Calandra Buonaura
Piero Parchi
author_sort Simone Baiardi
collection DOAJ
description Abstract Neurofilament light chain protein (NfL) is a valuable biomarker for the differential diagnosis between Parkinson’s disease (PD) and atypical parkinsonian disorders (APD). Here, we compared the performance of four cerebrospinal fluid (CSF) and three plasma NfL immunoassays in 253 PD and 265 APD. We measured NfL by ELISA in CSF and by SiMoA, CLEIA, and ELLA in both CSF and plasma. Additionally, we assessed Lewy body pathology by CSF α-synuclein real-time quaking-induced conversion assay (α-syn-RT-QuIC). In each biofluid, the tested assays showed comparable precision; however, CSF NfL showed higher diagnostic accuracy than plasma NfL for discriminating PD from APD (AUC range 0.966–0.974 vs 0.917–0.924). Combining CSF NfL and α-syn-RT-QuIC increased diagnostic accuracy. These results confirm the high diagnostic value of NfL in patients with parkinsonism, even when different assays are used. Combining CSF NfL and α-syn-RT-QuIC provides the highest accuracy, followed by CSF NfL and plasma NfL.
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spelling doaj-art-0f9ba39620a441e4a55f971ffa83eca82025-08-20T02:10:49ZengNature Portfolionpj Parkinson's Disease2373-80572025-04-011111910.1038/s41531-025-00951-yHead-to-head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in ParkinsonismSimone Baiardi0Marcello Rossi1Giulia Giannini2Angela Mammana3Barbara Polischi4Luisa Sambati5Andrea Mastrangelo6Franco Magliocchetti7Pietro Cortelli8Sabina Capellari9Giovanna Calandra Buonaura10Piero Parchi11Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of BolognaIRCCS Istituto delle Scienze Neurologiche di BolognaDepartment of Biomedical and Neuromotor Sciences (DiBiNeM), University of BolognaIRCCS Istituto delle Scienze Neurologiche di BolognaIRCCS Istituto delle Scienze Neurologiche di BolognaIRCCS Istituto delle Scienze Neurologiche di BolognaDepartment of Biomedical and Neuromotor Sciences (DiBiNeM), University of BolognaIRCCS Istituto delle Scienze Neurologiche di BolognaDepartment of Biomedical and Neuromotor Sciences (DiBiNeM), University of BolognaDepartment of Biomedical and Neuromotor Sciences (DiBiNeM), University of BolognaDepartment of Biomedical and Neuromotor Sciences (DiBiNeM), University of BolognaDepartment of Biomedical and Neuromotor Sciences (DiBiNeM), University of BolognaAbstract Neurofilament light chain protein (NfL) is a valuable biomarker for the differential diagnosis between Parkinson’s disease (PD) and atypical parkinsonian disorders (APD). Here, we compared the performance of four cerebrospinal fluid (CSF) and three plasma NfL immunoassays in 253 PD and 265 APD. We measured NfL by ELISA in CSF and by SiMoA, CLEIA, and ELLA in both CSF and plasma. Additionally, we assessed Lewy body pathology by CSF α-synuclein real-time quaking-induced conversion assay (α-syn-RT-QuIC). In each biofluid, the tested assays showed comparable precision; however, CSF NfL showed higher diagnostic accuracy than plasma NfL for discriminating PD from APD (AUC range 0.966–0.974 vs 0.917–0.924). Combining CSF NfL and α-syn-RT-QuIC increased diagnostic accuracy. These results confirm the high diagnostic value of NfL in patients with parkinsonism, even when different assays are used. Combining CSF NfL and α-syn-RT-QuIC provides the highest accuracy, followed by CSF NfL and plasma NfL.https://doi.org/10.1038/s41531-025-00951-y
spellingShingle Simone Baiardi
Marcello Rossi
Giulia Giannini
Angela Mammana
Barbara Polischi
Luisa Sambati
Andrea Mastrangelo
Franco Magliocchetti
Pietro Cortelli
Sabina Capellari
Giovanna Calandra Buonaura
Piero Parchi
Head-to-head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in Parkinsonism
npj Parkinson's Disease
title Head-to-head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in Parkinsonism
title_full Head-to-head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in Parkinsonism
title_fullStr Head-to-head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in Parkinsonism
title_full_unstemmed Head-to-head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in Parkinsonism
title_short Head-to-head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in Parkinsonism
title_sort head to head comparison of four cerebrospinal fluid and three plasma neurofilament light chain assays in parkinsonism
url https://doi.org/10.1038/s41531-025-00951-y
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