CSF neurofilament light chain and tau differentiate multiple system atrophy from Parkinson's disease

Neurobiol Aging. 2007 May;28(5):742-7. doi: 10.1016/j.neurobiolaging.2006.03.010. Epub 2006 May 6.


Background: In early disease stages it can be clinically difficult to differentiate idiopathic Parkinson's disease (IPD) from patients with multiple system atrophy predominated by parkinsonism (MSA-P).

Methods: In CSF of 31 patients with IPD, 19 patients with MSA-P, we analyzed tau, neurofilament light chain (NFL) and heavy chain (NFHp35) and the noradrenergic metabolite 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG).

Results: CSF levels of NFL, NFHp35, and tau were significantly increased in MSA-P (all p<0.0001), whereas, MHPG levels were significantly decreased in MSA-P (p<0.0001). Optimal discriminative cut-off values for the differentiation between MSA-P and IPD were calculated resulting in high sensitivity (76-94%) and specificity (83-97%) levels. Multivariate logistic regression resulted in the combination of NFL and tau as independent contributors in differentiating between MSA-P and IPD.

Discussion: Higher CSF levels of axonal biomarkers could reflect advanced axonal degeneration in MSA-P. Differentiating MSA-P from IPD could be accurately possible with CSF analysis of a combination of axonal and neurotransmitter biomarkers.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / cerebrospinal fluid
  • Follow-Up Studies
  • Humans
  • Methoxyhydroxyphenylglycol / cerebrospinal fluid
  • Middle Aged
  • Multiple System Atrophy / cerebrospinal fluid*
  • Multiple System Atrophy / epidemiology
  • Neurofilament Proteins / cerebrospinal fluid*
  • Parkinson Disease / cerebrospinal fluid*
  • Parkinson Disease / epidemiology
  • Retrospective Studies
  • tau Proteins / cerebrospinal fluid*


  • Biomarkers
  • Neurofilament Proteins
  • neurofilament protein L
  • tau Proteins
  • Methoxyhydroxyphenylglycol