Open AccessNeurofilament as a potential biomarker for spinal muscular atrophy
Author(s) -
Darras Basil T.,
Crawford Thomas O.,
Finkel Richard S.,
Mercuri Eugenio,
De Vivo Darryl C.,
Oskoui Maryam,
Tizzano Eduardo F.,
Ryan Monique M.,
Muntoni Francesco,
Zhao Guolin,
Staropoli John,
McCampbell Alexander,
Petrillo Marco,
Stebbins Christopher,
Fradette Stephanie,
Farwell Wildon,
Sumner Charlotte J.
Publication year - 2019
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.779
Subject(s) - sma* , medicine , spinal muscular atrophy , biomarker , neuromuscular disease , atrophy , neurofilament , gastroenterology , disease , biochemistry , chemistry , immunohistochemistry , mathematics , combinatorics
Objective To evaluate plasma phosphorylated neurofilament heavy chain ( pNF ‐H) as a biomarker in spinal muscular atrophy ( SMA ). Methods Levels of pNF ‐H were measured using the ProteinSimple ® platform in plasma samples from infants with SMA enrolled in ENDEAR ( NCT 02193074) and infants/children without neurological disease. Results Median pNF ‐H plasma level was 167.0 pg/mL (7.46–7,030; n = 34) in children without SMA (aged 7 weeks–18 years) and was higher in those aged < 1 versus 1–18 years ( P = 0.0002). In ENDEAR participants with infantile‐onset SMA , median baseline pNF ‐H level (15,400 pg/mL; 2390–50,100; n = 117) was ~10‐fold higher than that of age‐matched infants without SMA ( P < 0.0001) and ~90‐fold higher than children without SMA ( P < 0.0001). Higher pretreatment pNF ‐H levels in infants with SMA were associated with younger age at symptom onset, diagnosis, and first dose; lower baseline Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders score; and lower peroneal compound muscle potential amplitude. Nusinersen treatment was associated with a rapid and greater decline in pNF ‐H levels: nusinersen‐treated infants experienced a steep 71.9% decline at 2 months to 90.1% decline at 10 months; sham control–treated infants declined steadily by 16.2% at 2 months and 60.3% at 10 months. Interpretation Plasma pNF ‐H levels are elevated in infants with SMA . Levels inversely correlate with age at first dose and several markers of disease severity. Nusinersen treatment is associated with a significant decline in pNF ‐H levels followed by relative stabilization. Together these data suggest plasma pNF ‐H is a promising marker of disease activity/treatment response in infants with SMA.