Summary
- A recent study found that patients with Parkinson’s disease (PD) had higher serum levels of neurofilament light chain (NFL) than controls, and NFL was associated with age.
- Increased baseline serum NFL level was associated with greater cognitive decline over 10 years: a steeper decrease in Mini-Mental State Examination (MMSE) scores among the PD group.
- Although NFL at baseline was not significantly associated with short-term motor impairment, and increase in NFL was a predictor of motor disability and worsening of symptoms over a period of five years.
- The study highlights that serum NFL can be a useful marker for the predictino of cognitive decline and disease progression, allowing for earlier intervention and better management strategies.
An interesting recent study on Parkinson’s disease (PD) provides new insights into how to predict cognitive decline. In a study of 392 subjects, with or without PD, those who had PD also had higher levels in a blood sample of serum neurofilament light chain (NFL) as compared to control samples. The concentration of this protein in blood was associated with age as well, both in PD patients and controls.
In this study, patients with PD were found to have less education and lower scores on the Mini-Mental State Examination (MMSE) compared with controls. Furthermore, the study demonstrated that a faster MMSE decline in PD patients over 10 years was more pronounced with higher baseline serum NFL levels.
The also examined the relation of serum NFL levels with motor impairment in patients suffering from PD. For the entire sample, the annual increase in motor disability as calculated by change from baseline to 12 months in Unified Parkinson’s Disease Rating Scale Part III (UPDRS III) scores was not associated with serum NFL level at study entry. Nevertheless, a higher level of NFL at baseline was associated with a greater UPDRS III score 5 years later and predicted an increase in worsening motor impairment over time.
Therefore, serum NFL might be an interesting candidate biomarker to predict cognitive decline in Parkinson disease. Through understanding the temporal dynamics of NFL levels, clinicians might be able to identify persons at high risk for cognitive impairment and start interventions early on in order to delay disease progression.
These findings underscore the need to unveil mechanisms underlying cognitive decline in PD, as well as for investigational blood biomarkers able to predict disease trajectory. Serum NFL levels may one day be a useful tool in the clinical management of PD, ultimately improving outcomes and quality of life for patients after further research and validation.
The findings of this study may suggest that serum NFL might act as a good predictor to reflect cognition dysfunction in patients progressed from PD. This will allow healthcare providers to detect those at an elevated risk of developing cognitive impairment and adjust interventions and support strategies accordingly, leading to improved disease management and patient outcomes. The study is another step toward earlier detection and more customized clinical intervention that could change patient care going forward.