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. 2020 Jan;267(1):162-167.
doi: 10.1007/s00415-019-09567-8. Epub 2019 Oct 8.

Serum Neurofilament Light Chain Is a Discriminative Biomarker Between Frontotemporal Lobar Degeneration and Primary Psychiatric Disorders

Free PMC article

Serum Neurofilament Light Chain Is a Discriminative Biomarker Between Frontotemporal Lobar Degeneration and Primary Psychiatric Disorders

Kasper Katisko et al. J Neurol. .
Free PMC article


Due to the significant clinical overlap between frontotemporal lobar degeneration (FTLD) spectrum disorders and late-onset primary psychiatric disorders (PPD), diagnostic biomarkers reflecting the different underlying pathophysiologies are urgently needed. Thus far, elevated cerebrospinal fluid (CSF) levels of neurofilament light chain (NfL) have been reported in various neurological conditions. Furthermore, recent advancements in ultrasensitive analytical methods (e.g., single molecule array, Simoa) have enabled sensitive and less invasive NfL detection also from blood samples. In this study, we evaluated the potential of serum NfL (sNfL) as a diagnostic tool between FTLD and PPD. We analyzed sNfL levels with Simoa from 125 participants including patients from FTLD (n = 91) and PPD (n = 34) spectra. Our results show that sNfL levels are higher in the FTLD group compared to the PPD group as well as in separate clinical subtypes of FTLD compared to different psychiatric manifestations (i.e., mood or psychotic disorders). At single-subject level, discrimination between FTLD and PPD was possible with 80% sensitivity and 85% specificity (AUC = 0.850, 95% CI 0.776-0.923), and between behavioral variant frontotemporal dementia (bvFTD) and PPD with 79% sensitivity and 85% specificity (AUC = 0.830, 95% CI 0.732-0.908). These findings highlight the potential of sNfL as a discriminating biomarker for FTLD over PPD in patients with wide-ranging behavioral, psychiatric and cognitive symptoms.

Keywords: Biomarker; Frontotemporal dementia; Frontotemporal lobar degeneration; Neurofilament light (NfL); Psychiatric disorders; sNfL.

Conflict of interest statement

The authors declare that they have no conflict of interest.


Fig. 1
Fig. 1
SNfL concentrations representing each case in each group with group medians and interquartile ranges (IQR). Statistical comparison was performed with general linear model (each of the comparisons made separately) with age as a covariate. sNfL serum neurofilament light, FTLD frontotemporal lobar degeneration, bvFTD behavioral variant frontotemporal dementia, PPA primary progressive aphasia, FTLD-MND frontotemporal lobar degeneration with motor neuron disease, PPD primary psychiatric disorders

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