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Plasma neurofilament light chain as a predictor of multiple system atrophy in idiopathic REM sleep behavior disorder
Bora Jin, Seoyeon Kim, Seungmin Lee, Su Hyeon Ha, Kyung Ah Woo, Jung Hwan Shin, Ki-Young Jung, Han-Joon Kim. Journal of neurology, 2025-12-08
Topic: Plasma and spinal-fluid biomarkers
Over 3.7 years, 22 patients phenoconverted (7 multiple system atrophy [MSA]; 15 Lewy body diseases [LBDs]). Baseline NfL levels were higher in converters (median, 14.00 pg/mL), especially MSA converters (16.10 pg/mL), than in non-converters (11.15 pg/mL) and HCs (11.55 pg/mL) (p = 0.025 and p = 0.009, respectively). Baseline GFAP and DDC levels did not differ. In MSA converters, NfL correlated with SCOPA-AUT score (r = 0.925, p = 0.008), and a cutoff of 12.60 pg/mL predicted MSA phenoconversion (sensitivity 100%, specificity 62.8%, AUC = 0.83, p = 0.003). Post-phenoconversion NfL levels were elevated in converters (18.80 pg/mL) than in non-converters (13.05 pg/mL) (p < 0.001), highest in MSA converters (24.45 pg/mL; p < 0.001). GFAP showed a marginal increase (p = 0.051), while DDC showed no significant differences. Plasma NfL is a promising biomarker for predicting phenoconversion in iRBD, particularly to MSA, and may reflect underlying autonomic dysfunction.
Key findings
- Over 3.7 years, 22 patients phenoconverted (7 multiple system atrophy [MSA]; 15 Lewy body diseases [LBDs]).
- Baseline NfL levels were higher in converters (median, 14.00 pg/mL), especially MSA converters (16.10 pg/mL), than in non-converters (11.15 pg/mL) and HCs (11.55 pg/mL) (p = 0.025 and p = 0.009, respectively).
- Baseline GFAP and DDC levels did not differ.
- In MSA converters, NfL correlated with SCOPA-AUT score (r = 0.925, p = 0.008), and a cutoff of 12.60 pg/mL predicted MSA phenoconversion (sensitivity 100%, specificity 62.8%, AUC = 0.83, p = 0.003).
- Post-phenoconversion NfL levels were elevated in converters (18.80 pg/mL) than in non-converters (13.05 pg/mL) (p < 0.001), highest in MSA converters (24.45 pg/mL; p < 0.001).
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Study details
- Participants22
- Effect size62.8%; AUC = 0.83
- Evidence strengthLow
How this study scored 55/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 31 of the 56 points we could judge it on, which is 55 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of neurology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 22 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41359208) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 31 / 56 | Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 31 of the 56 points we could judge it on is 55 out of 100. |
| Total | 55 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Jin, B., Kim, S., Lee, S., Ha, S. H., Woo, K. A., Shin, J. H., et al. (2025). Plasma neurofilament light chain as a predictor of multiple system atrophy in idiopathic REM sleep behavior disorder. Journal of neurology. https://doi.org/10.1007/s00415-025-13559-2
Vancouver
Jin B, Kim S, Lee S, Ha SH, Woo KA, Shin JH, et al. Plasma neurofilament light chain as a predictor of multiple system atrophy in idiopathic REM sleep behavior disorder. Journal of neurology. 2025. doi:10.1007/s00415-025-13559-2. PMID: 41359208.
BibTeX
@article{jin2025-41359208,
author = {Jin, Bora and Kim, Seoyeon and Lee, Seungmin and Ha, Su Hyeon and Woo, Kyung Ah and Shin, Jung Hwan and Jung, Ki-Young and Kim, Han-Joon},
title = {{Plasma neurofilament light chain as a predictor of multiple system atrophy in idiopathic REM sleep behavior disorder}},
journal = {Journal of neurology},
year = {2025},
doi = {10.1007/s00415-025-13559-2},
pmid = {41359208},
url = {https://doi.org/10.1007/s00415-025-13559-2}
}
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