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Plasma Neurofilament Light as a Biomarker of Neurological Involvement in Wilson's Disease
Author(s) -
Shribman Samuel,
Heller Carolin,
Burrows Maggie,
Heslegrave Amanda,
Swift Imogen,
Foiani Martha S.,
Gillett Godfrey T.,
Tsochatzis Emmanuel A.,
Rowe James B.,
Gerhard Alex,
Butler Chris R.,
Masellis Mario,
Bremner Fion,
Martin Alison,
Jung Lynne,
Cook Paul,
Zetterberg Henrik,
Bandmann Oliver,
Rohrer Jonathan D.,
Warner Thomas T.
Publication year - 2021
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.28333
Subject(s) - biomarker , neurological examination , medicine , disease , wilson's disease , rating scale , parkinson's disease , chelation therapy , neurofilament , neurology , oncology , pathology , psychology , surgery , psychiatry , immunohistochemistry , developmental psychology , biochemistry , chemistry , thalassemia
Background Outcomes are unpredictable for neurological presentations of Wilson's disease (WD). Dosing regimens for chelation therapy vary and monitoring depends on copper indices, which do not reflect end‐organ damage. Objective To identify a biomarker for neurological involvement in WD. Methods Neuronal and glial‐specific proteins were measured in plasma samples from 40 patients and 38 age‐matched controls. Patients were divided into neurological or hepatic presentations and those with recent neurological presentations or deterioration associated with non‐adherence were subcategorized as having active neurological disease. Unified WD Rating Scale scores and copper indices were recorded. Results Unlike copper indices, neurofilament light (NfL) concentrations were higher in neurological than hepatic presentations. They were also higher in those with active neurological disease when controlling for severity and correlated with neurological examination subscores in stable patients. Conclusion NfL is a biomarker of neurological involvement with potential use in guiding chelation therapy and clinical trials for novel treatments. © 2020 University College London. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society