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Increased cerebrospinal fluid levels of neurofilament protein in progressive supranuclear palsy and multiple-system atrophy compared with Parkinson's disease.
Mov Disord. 1998 Jan; 13(1):70-7.MD

Abstract

More reliable tools are needed for the differentiation of Parkinson's disease (PD) from other parkinsonian disorders. The neurofilament protein (NFL) and the glial fibrillary acidic protein (GFAP) are main structural proteins of axons and fibrillary astroglial cells. By using enzyme-linked immunosorbent assays, these proteins were quantified in the cerebrospinal fluid (CSF) of 49 patients referred to the Department of Neurology for diagnostic consideration or treatment of parkinsonism of different etiologies. All patients were first diagnostically evaluated by strict clinical criteria. The procedure included a neurologic and neuro-ophthalmologic examination as well as computed tomography or magnetic resonance imaging. These were performed independently and in advance of the CSF analysis. A total of 19 patients were diagnosed as having PD, 12 had progressive supranuclear palsy (PSP), and 10 had multiple-system atrophy (MSA). Eight were diagnosed as having other diseases, such as arteriosclerotic parkinsonism and undefined parkinsonian syndromes. The content of NFL was significantly higher both in the PSP group (p < 0.001) and in the MSA group (p < 0.0001) compared with the PD group. The high values of NFL indicate an ongoing neuronal degeneration affecting mainly the axonal compartment in the PSP and MSA groups, whereas there was no difference in glial involvement as measured by GFAP in the PD, PSP, and MSA groups. There was a relation between high CSF levels of NFL in the various patient groups and the occurrence of pyramidal symptoms (p < 0.001), possibly reflecting the axonal damage to the corticospinal tract. Furthermore, mortality at 24-month follow up was associated with high NFL levels (p < 0.01). We conclude that analysis of NFL in CSF may become useful in the differential diagnosis of parkinsonian syndromes.

Authors+Show Affiliations

Institute of Clinical Neuroscience, Department of Neurology, University of Göteborg, Sahlgren's Hospital, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9452329

Citation

Holmberg, B, et al. "Increased Cerebrospinal Fluid Levels of Neurofilament Protein in Progressive Supranuclear Palsy and Multiple-system Atrophy Compared With Parkinson's Disease." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 13, no. 1, 1998, pp. 70-7.
Holmberg B, Rosengren L, Karlsson JE, et al. Increased cerebrospinal fluid levels of neurofilament protein in progressive supranuclear palsy and multiple-system atrophy compared with Parkinson's disease. Mov Disord. 1998;13(1):70-7.
Holmberg, B., Rosengren, L., Karlsson, J. E., & Johnels, B. (1998). Increased cerebrospinal fluid levels of neurofilament protein in progressive supranuclear palsy and multiple-system atrophy compared with Parkinson's disease. Movement Disorders : Official Journal of the Movement Disorder Society, 13(1), 70-7.
Holmberg B, et al. Increased Cerebrospinal Fluid Levels of Neurofilament Protein in Progressive Supranuclear Palsy and Multiple-system Atrophy Compared With Parkinson's Disease. Mov Disord. 1998;13(1):70-7. PubMed PMID: 9452329.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased cerebrospinal fluid levels of neurofilament protein in progressive supranuclear palsy and multiple-system atrophy compared with Parkinson's disease. AU - Holmberg,B, AU - Rosengren,L, AU - Karlsson,J E, AU - Johnels,B, PY - 1998/2/6/pubmed PY - 1998/2/6/medline PY - 1998/2/6/entrez SP - 70 EP - 7 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 13 IS - 1 N2 - More reliable tools are needed for the differentiation of Parkinson's disease (PD) from other parkinsonian disorders. The neurofilament protein (NFL) and the glial fibrillary acidic protein (GFAP) are main structural proteins of axons and fibrillary astroglial cells. By using enzyme-linked immunosorbent assays, these proteins were quantified in the cerebrospinal fluid (CSF) of 49 patients referred to the Department of Neurology for diagnostic consideration or treatment of parkinsonism of different etiologies. All patients were first diagnostically evaluated by strict clinical criteria. The procedure included a neurologic and neuro-ophthalmologic examination as well as computed tomography or magnetic resonance imaging. These were performed independently and in advance of the CSF analysis. A total of 19 patients were diagnosed as having PD, 12 had progressive supranuclear palsy (PSP), and 10 had multiple-system atrophy (MSA). Eight were diagnosed as having other diseases, such as arteriosclerotic parkinsonism and undefined parkinsonian syndromes. The content of NFL was significantly higher both in the PSP group (p < 0.001) and in the MSA group (p < 0.0001) compared with the PD group. The high values of NFL indicate an ongoing neuronal degeneration affecting mainly the axonal compartment in the PSP and MSA groups, whereas there was no difference in glial involvement as measured by GFAP in the PD, PSP, and MSA groups. There was a relation between high CSF levels of NFL in the various patient groups and the occurrence of pyramidal symptoms (p < 0.001), possibly reflecting the axonal damage to the corticospinal tract. Furthermore, mortality at 24-month follow up was associated with high NFL levels (p < 0.01). We conclude that analysis of NFL in CSF may become useful in the differential diagnosis of parkinsonian syndromes. SN - 0885-3185 UR - https://www.unboundmedicine.com/medline/citation/9452329/Increased_cerebrospinal_fluid_levels_of_neurofilament_protein_in_progressive_supranuclear_palsy_and_multiple_system_atrophy_compared_with_Parkinson's_disease_ L2 - https://doi.org/10.1002/mds.870130116 DB - PRIME DP - Unbound Medicine ER -