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Neurofilament light chain in serum for the diagnosis of amyotrophic lateral sclerosis
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    RE: Neurofilament light chain in serum for the diagnosis of amyotrophic lateral sclerosis

    Verde et al. conducted a prospective study to determine the diagnostic and prognostic performance of serum neurofilament light chain (NFL) in patients with amyotrophic lateral sclerosis (ALS) (1). Serum NFL positively correlated with disease progression rate in patients with ALS, and higher levels were significantly associated with shorter survival. In addition, serum NFL did not differ among patients in different ALS pathological stages, and NFL levels were stable over time within each patient. I have a concern about their study.

    Gille et al. also recognized the relationship of serum NFL with motor neuron degeneration in patients with ALS (2). They also recognized that serum NFL was significantly associated with disease progression rate and survival. Serum NFL can be recommended as a surrogate biomarker of ALS.

    Regarding the first concern, Thouvenot et al. also checked if serum NFL can be used as a prognostic marker for ALS at the time of diagnosis (3). By Cox regression analysis, NFL, weight loss and site at onset were independent predictive factors of mortality, and higher NFL concentration at the time of diagnosis is the strongest prognostic fact

    I recently discussed on serum neurofilament light chain in patients with amyotrophic lateral sclerosis (4), and these consistent results should also be verified by a meta-analysis of prospective studies.

    References

    1. Verde F, Steinacker P, Weishaupt JH, et al. Neurofilament light chain in se...

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    Conflict of Interest:
    None declared.