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Serum neurofilament dynamics predicts neurodegeneration and clinical progression in presymptomatic Alzheimer's disease
Preische O, Schultz SA, Apel A, Kuhle J, Kaeser SA, Barro C, et al., for the Dominantly Inherited Alzheimer Network. Nature Medicine, 2019-02
Topic: Amyloid, tau and blood-test diagnosis
This study showed that a simple blood test measuring neurofilament light (NfL), a protein released when brain cells are damaged, can detect the earliest signs of brain degeneration in people carrying genes that cause early-onset familial Alzheimer's disease - years before any symptoms appear. Watching how fast NfL rises over time worked even better than a single measurement.
Key findings
- 405 people (243 mutation carriers, 162 non-carrier controls) from the DIAN study had serum NfL measured
- Rate of change in NfL over time distinguished future patients from healthy relatives 16.2 years before expected symptom onset
- A single baseline NfL level only distinguished the groups about 6.8 years before onset
- NfL trajectory correlated with cortical thinning, particularly in the precuneus, and with cognitive decline
Why it matters
In people with inherited Alzheimer's disease, the rate of change of serum neurofilament light distinguished mutation carriers from non-carriers about a decade earlier than single measurements and predicted brain shrinkage and cognitive change. This is a marker of progression, not a treatment or cure.
Study details
- Study designcohort
- Participants405
- Effect sizeRate of change in serum NfL discriminated mutation carriers from non-carriers approximately 16.2 years before estimated symptom onset, versus 6.8 years using a single baseline NfL measurement
- Evidence strengthHigh
Limitations
Conducted only in people with rare, autosomal-dominant (inherited) early-onset Alzheimer's mutations, which may not fully generalize to common late-onset sporadic Alzheimer's; NfL is a general neurodegeneration marker, not specific to Alzheimer's pathology.
How this study scored 66/100
Published in a top-tier journal, and it is a cohort study following people over time. Scored zero for randomised / blinded and indexed in PubMed 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, 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 41 of the 62 points we could judge it on, which is 66 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Nature Medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2019 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 405 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 0 / 6 | No other study in this library cites it |
| 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 | 0 / 2 | No PubMed ID and no DOI — scores zero (not stated in the record — scored 0) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 41 / 62 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 41 of the 62 points we could judge it on is 66 out of 100. |
| Total | 66 / 100 | — |
What each of these 20 components measures, and what this score is not →
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. This record has no DOI, so the citation leaves it out. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Preische, O., Schultz, S. A., Apel, A., Kuhle, J., Kaeser, S. A., Barro, C., et al. (2019). Serum neurofilament dynamics predicts neurodegeneration and clinical progression in presymptomatic Alzheimer's disease. Nature Medicine.
Vancouver
Preische O, Schultz SA, Apel A, Kuhle J, Kaeser SA, Barro C, et al. Serum neurofilament dynamics predicts neurodegeneration and clinical progression in presymptomatic Alzheimer's disease. Nature Medicine. 2019. PMID: 30664784.
BibTeX
@article{preische2019-9106bc9f,
author = {Preische, O. and Schultz, S. A. and Apel, A. and Kuhle, J. and Kaeser, S. A. and Barro, C. and {Dominantly Inherited Alzheimer Network} and others},
title = {{Serum neurofilament dynamics predicts neurodegeneration and clinical progression in presymptomatic Alzheimer's disease}},
journal = {Nature Medicine},
year = {2019},
pmid = {30664784}
}
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