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Dupont J, Vercauteren L, Amini N, Lapauw L, De Schaepdryver M, Poesen K, Dedeyne L, Verschueren S, Tournoy J, Koppo K, Gielen E. Are inflammatory markers associated with sarcopenia-related traits in older adults with sarcopenia? - A cross-sectional analysis of the ENHANce study. Exp Gerontol 2023; 178:112196. [PMID: 37156446 DOI: 10.1016/j.exger.2023.112196] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/06/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
AIMS To explore the relationship between inflammatory markers and sarcopenia-related traits in sarcopenic older adults. METHODS Baseline data of the ongoing Exercise and Nutrition for Healthy AgeiNg (ENHANce) study were used for a secondary, exploratory, cross-sectional analysis. ENHANce is a 5-armed triple blinded randomized controlled trial, in older adults (>65y) with sarcopenia defined according to the revised criteria of the European Working Group of Sarcopenia in Older People (EWGSOP2) aiming to assess the effect of combined anabolic interventions (protein supplement, omega-3 supplement and physical exercise) on physical performance, compared to single/placebo interventions. Inflammatory markers C-reactive protein (hs-CRP), albumin, interleukin-1β (IL-1β), IL-6, IL-8, and tumour necrosis factor-α (TNF-α) were assessed at baseline. Spearman's rho (ρ) correlation coefficients were calculated to associate these inflammatory markers with baseline sarcopenia-defining parameters (handgrip strength, chair stand test, appendicular lean mass [aLM], gait speed, Short Physical Performance Battery), physical activity (step count) and quality of life (SF-36, SarQoL). RESULTS We included 40 sarcopenic subjects (15 men/25 women, age 77.1 ± 6.8 years). Contrary to expectations, the pro-inflammatory IL-1β correlated positively with handgrip strength (ρ: 0.376; p = 0.024) and IL-6 with aLM (ρ: 0.334; p = 0.0433). IL-6 inversely correlated with step count (ρ:-0.358; p = 0.048). Subgroup analysis revealed important gender differences. IL-8 inversely correlated with handgrip strength in women (ρ: -0.425; p = 0.034) but not in men. In contrast, pro-inflammatory cytokines CRP (ρ: -0.615; p = 0.019), IL-6 (ρ: -0.604; p = 0.029) and TNF-α (ρ: -0.615; p = 0.025) inversely correlated with the SF-36 physical component score in men but not in women. CONCLUSION Although Inflammageing might play a role in sarcopenia-related traits, this exploratory study highlights an important role of gender. Future research should take this into account when elucidating the Inflammageing-sarcopenia interplay.
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Affiliation(s)
- Jolan Dupont
- Geriatrics & Gerontology, Department of Public Health and Primary Care, KU Leuven, Belgium; Department of Geriatric Medicine, UZ Leuven, Belgium.
| | - Laura Vercauteren
- Geriatrics & Gerontology, Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Nadjia Amini
- Geriatrics & Gerontology, Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Laurence Lapauw
- Geriatrics & Gerontology, Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Maxim De Schaepdryver
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Lenore Dedeyne
- Geriatrics & Gerontology, Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Sabine Verschueren
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Jos Tournoy
- Geriatrics & Gerontology, Department of Public Health and Primary Care, KU Leuven, Belgium; Department of Geriatric Medicine, UZ Leuven, Belgium
| | - Katrien Koppo
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Belgium
| | - Evelien Gielen
- Geriatrics & Gerontology, Department of Public Health and Primary Care, KU Leuven, Belgium; Department of Geriatric Medicine, UZ Leuven, Belgium
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De Schaepdryver M, Masrori P, Van Damme P, Poesen K. Effect of neurofilament analysis on the diagnostic delay in amyotrophic lateral sclerosis. CNS Neurosci Ther 2022; 29:70-77. [PMID: 36047371 PMCID: PMC9804063 DOI: 10.1111/cns.13960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 08/14/2022] [Accepted: 08/18/2022] [Indexed: 02/06/2023] Open
Abstract
AIMS The aim of this study was to investigate whether neurofilament light (NfL) and phosphorylated neurofilament heavy (pNfH) in cerebrospinal fluid (CSF), sampled prior to referral to a neuromuscular reference center (NMRC), shorten the diagnostic delay in patients with amyotrophic lateral sclerosis. METHODS In this retrospective study, patients with ALS were included with (i) determination of neurofilaments (Nfs) before referral to the NMRC (preC-Nfs ALS, n = 58), (ii) determination of Nfs at the NMRC (C-Nfs, n = 54) or (iii) with no determination of Nfs (C-No Nfs, n = 180). Fifty-six disease controls were included. RESULTS The preC-Nfs cohort had CSF sampled 2.2 months (range: 0.6-12.0 months) before referral to the NMRC. In this cohort, the diagnostic delay was significantly shorter [median (range): 8.24 (2.37-49.7) months] than in the C-Nfs cases [median (range): 11.4 (2.93-86.5) months; p < 0.05], but not in the C-No Nfs cases. When including the disease progression rate and the presence of a genetic mutation as covariates, the difference ceased to exist (p = 0.14). pNfH and NfL levels in the preC-Nfs cohort were significantly higher than in disease controls (p < 0.0001). Both Nfs showed a similar discriminating performance. CONCLUSIONS CSF Nfs assessed before the diagnosis of ALS at a NMRC decreased the diagnostic delay in specific cases by 3 months and only when other covariates were not taken into account.
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Affiliation(s)
- Maxim De Schaepdryver
- Laboratory for Molecular Neurobiomarker Research, Department of NeurosciencesLeuven Brain Institute, KU LeuvenLeuvenBelgium
| | - Pegah Masrori
- Laboratory of NeurobiologyCenter for Brain & Disease Research, VIBLeuvenBelgium,Department of NeurologyUniversity Hospitals LeuvenLeuvenBelgium,Experimental Neurology, Department of NeurosciencesLeuven Brain Institute, KU LeuvenLeuvenBelgium
| | - Philip Van Damme
- Laboratory of NeurobiologyCenter for Brain & Disease Research, VIBLeuvenBelgium,Department of NeurologyUniversity Hospitals LeuvenLeuvenBelgium,Experimental Neurology, Department of NeurosciencesLeuven Brain Institute, KU LeuvenLeuvenBelgium
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, Department of NeurosciencesLeuven Brain Institute, KU LeuvenLeuvenBelgium,Laboratory MedicineUniversity Hospitals LeuvenLeuvenBelgium
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De Wel B, De Schaepdryver M, Poesen K, Claeys KG. Biochemical and clinical biomarkers in adult SMA 3-4 patients treated with nusinersen for 22 months. Ann Clin Transl Neurol 2022; 9:1241-1251. [PMID: 35833245 PMCID: PMC9380134 DOI: 10.1002/acn3.51625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 11/11/2022] Open
Abstract
Objective To investigate biomarkers of disease progression in cerebrospinal fluid (CSF) and serum in adult patients with spinal muscular atrophy (SMA). Furthermore, we assess the clinical response to nusinersen treatment in adults with SMA over a longer follow‐up period than the previously reported 6–14 months. Methods We included 16 adults with SMA type 3–4 for nusinersen treatment over 22 months in this prospective study. We evaluated chitotriosidase‐1 (CHIT1) and chitinase‐3‐like protein 1 (YKL‐40) as neuroinflammatory biomarkers in CSF, and neurofilament light chain (NfL) and heavy chain (pNfH) as neurodegenerative markers in CSF and serum at baseline, month 6, 14 and 22, together with a wide range of clinical outcome measures. Results Levels of CHIT1 increased significantly (p = 0.048) throughout the 22‐month treatment period and pNfH decreased significantly (p = 0.022) in CSF, but both did not correlate with clinical outcome measures. YKL‐40 correlated strongly with neurofilaments in CSF (rho = 0.76) and decreased significantly (p = 0.037) in patients with improvements in the revised upper limb module (RULM). Finally, patients showed significant improvements in hand grip strength, hand motor function, medical research council (MRC) sum score, and peak expiratory flow (PEF) after 22 months of treatment. Interpretation YKL‐40 in CSF correlated with clinical improvements during nusinersen treatment. In contrast, CHIT1 and pNfH in CSF changed significantly during treatment but did not correlate with clinical outcomes. Finally, we demonstrated a sustained clinical effect of nusinersen treatment in adults after 22 months.
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Affiliation(s)
- Bram De Wel
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven Brain Institute (LBI), Leuven, Belgium
| | - Maxim De Schaepdryver
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven Brain Institute (LBI), Leuven, Belgium
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven Brain Institute (LBI), Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven Brain Institute (LBI), Leuven, Belgium
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4
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Masrori P, De Schaepdryver M, Floeter MK, De Vocht J, Lamaire N, D'Hondt A, Traynor B, Poesen K, Van Damme P. Prognostic relationship of neurofilaments, CHIT1, YKL-40 and MCP-1 in amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2022; 93:681-682. [PMID: 34911782 PMCID: PMC9148980 DOI: 10.1136/jnnp-2021-327877] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/01/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Pegah Masrori
- Neurology, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium.,Laboratory of Neurobiology, VIB KU Leuven Center for Brain and Disease Research, Leuven, Belgium
| | | | - Mary Kay Floeter
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Joke De Vocht
- Neurology, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium.,Laboratory of Neurobiology, VIB KU Leuven Center for Brain and Disease Research, Leuven, Belgium
| | - Nikita Lamaire
- Neurology, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium
| | - Ann D'Hondt
- Neurology, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium
| | - Bryan Traynor
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.,Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA.,Therapeutic Development Branch, National Center for Advancing Translational Sciences, NIH, Bethesda, Maryland, USA
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium
| | - Philip Van Damme
- Neurology, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium .,Laboratory of Neurobiology, VIB KU Leuven Center for Brain and Disease Research, Leuven, Belgium
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Månberg A, Skene N, Sanders F, Trusohamn M, Remnestål J, Szczepińska A, Aksoylu IS, Lönnerberg P, Ebarasi L, Wouters S, Lehmann M, Olofsson J, von Gohren Antequera I, Domaniku A, De Schaepdryver M, De Vocht J, Poesen K, Uhlén M, Anink J, Mijnsbergen C, Vergunst-Bosch H, Hübers A, Kläppe U, Rodriguez-Vieitez E, Gilthorpe JD, Hedlund E, Harris RA, Aronica E, Van Damme P, Ludolph A, Veldink J, Ingre C, Nilsson P, Lewandowski SA. Publisher Correction: Altered perivascular fibroblast activity precedes ALS disease onset. Nat Med 2021; 27:1308. [PMID: 34079107 DOI: 10.1038/s41591-021-01414-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Anna Månberg
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Nathan Skene
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
- Division of Neuroscience, Department of Brain Sciences, Imperial College London, London, UK
- United Kingdom Dementia Research Institute, London, UK
| | - Folkert Sanders
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Marta Trusohamn
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Julia Remnestål
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Anna Szczepińska
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Inci Sevval Aksoylu
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Peter Lönnerberg
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Lwaki Ebarasi
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Stefan Wouters
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Manuela Lehmann
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Jennie Olofsson
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Inti von Gohren Antequera
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Aylin Domaniku
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Maxim De Schaepdryver
- Laboratory for Neurobiomarker Research, Department of Neurology, Leuven Brain Institute, KU Leuven (University of Leuven), Leuven, Belgium
| | - Joke De Vocht
- Neurology Department and Center for Brain & Disease Research, KU Leuven, VIB, Leuven, Belgium
| | - Koen Poesen
- Laboratory for Neurobiomarker Research, Department of Neurology, Leuven Brain Institute, KU Leuven (University of Leuven), Leuven, Belgium
- Laboratory Medicine, UZ Leuven (University Hospital Leuven), Leuven, Belgium
| | - Mathias Uhlén
- Division of Systems Biology, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
- Department of Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jasper Anink
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Caroline Mijnsbergen
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Hermieneke Vergunst-Bosch
- UMC Utrecht Brain Center, University Medical Center Utrecht, Department of Neurology, Utrecht University, Utrecht, the Netherlands
| | - Annemarie Hübers
- University of Ulm, Neurology Clinic, Ulm, Germany
- Division of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Ulf Kläppe
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Elena Rodriguez-Vieitez
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Eva Hedlund
- Department of Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Robert A Harris
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Philip Van Damme
- Neurology Department and Center for Brain & Disease Research, KU Leuven, VIB, Leuven, Belgium
| | - Albert Ludolph
- University of Ulm, Neurology Clinic, Ulm, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Ulm, Bonn, Germany
| | - Jan Veldink
- UMC Utrecht Brain Center, University Medical Center Utrecht, Department of Neurology, Utrecht University, Utrecht, the Netherlands
| | - Caroline Ingre
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Peter Nilsson
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Sebastian A Lewandowski
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden.
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Månberg A, Skene N, Sanders F, Trusohamn M, Remnestål J, Szczepińska A, Aksoylu IS, Lönnerberg P, Ebarasi L, Wouters S, Lehmann M, Olofsson J, von Gohren Antequera I, Domaniku A, De Schaepdryver M, De Vocht J, Poesen K, Uhlén M, Anink J, Mijnsbergen C, Vergunst-Bosch H, Hübers A, Kläppe U, Rodriguez-Vieitez E, Gilthorpe JD, Hedlund E, Harris RA, Aronica E, Van Damme P, Ludolph A, Veldink J, Ingre C, Nilsson P, Lewandowski SA. Altered perivascular fibroblast activity precedes ALS disease onset. Nat Med 2021; 27:640-646. [PMID: 33859435 DOI: 10.1038/s41591-021-01295-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Abstract
Apart from well-defined factors in neuronal cells1, only a few reports consider that the variability of sporadic amyotrophic lateral sclerosis (ALS) progression can depend on less-defined contributions from glia2,3 and blood vessels4. In this study we use an expression-weighted cell-type enrichment method to infer cell activity in spinal cord samples from patients with sporadic ALS and mouse models of this disease. Here we report that patients with sporadic ALS present cell activity patterns consistent with two mouse models in which enrichments of vascular cell genes preceded microglial response. Notably, during the presymptomatic stage, perivascular fibroblast cells showed the strongest gene enrichments, and their marker proteins SPP1 and COL6A1 accumulated in enlarged perivascular spaces in patients with sporadic ALS. Moreover, in plasma of 574 patients with ALS from four independent cohorts, increased levels of SPP1 at disease diagnosis repeatedly predicted shorter survival with stronger effect than the established risk factors of bulbar onset or neurofilament levels in cerebrospinal fluid. We propose that the activity of the recently discovered perivascular fibroblast can predict survival of patients with ALS and provide a new conceptual framework to re-evaluate definitions of ALS etiology.
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Affiliation(s)
- Anna Månberg
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Nathan Skene
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden.,Division of Neuroscience, Department of Brain Sciences, Imperial College London, London, UK.,United Kingdom Dementia Research Institute, London, UK
| | - Folkert Sanders
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Marta Trusohamn
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Julia Remnestål
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Anna Szczepińska
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Inci Sevval Aksoylu
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Peter Lönnerberg
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Lwaki Ebarasi
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Stefan Wouters
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Manuela Lehmann
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Jennie Olofsson
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Inti von Gohren Antequera
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Aylin Domaniku
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Maxim De Schaepdryver
- Laboratory for Neurobiomarker Research, Department of Neurology, Leuven Brain Institute, KU Leuven (University of Leuven), Leuven, Belgium
| | - Joke De Vocht
- Neurology Department and Center for Brain & Disease Research, KU Leuven, VIB, Leuven, Belgium
| | - Koen Poesen
- Laboratory for Neurobiomarker Research, Department of Neurology, Leuven Brain Institute, KU Leuven (University of Leuven), Leuven, Belgium.,Laboratory Medicine, UZ Leuven (University Hospital Leuven), Leuven, Belgium
| | - Mathias Uhlén
- Division of Systems Biology, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden.,Department of Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jasper Anink
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Caroline Mijnsbergen
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Hermieneke Vergunst-Bosch
- UMC Utrecht Brain Center, University Medical Center Utrecht, Department of Neurology, Utrecht University, Utrecht, the Netherlands
| | - Annemarie Hübers
- University of Ulm, Neurology Clinic, Ulm, Germany.,Division of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Ulf Kläppe
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Elena Rodriguez-Vieitez
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Eva Hedlund
- Department of Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Robert A Harris
- Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Philip Van Damme
- Neurology Department and Center for Brain & Disease Research, KU Leuven, VIB, Leuven, Belgium
| | - Albert Ludolph
- University of Ulm, Neurology Clinic, Ulm, Germany.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Ulm, Bonn, Germany
| | - Jan Veldink
- UMC Utrecht Brain Center, University Medical Center Utrecht, Department of Neurology, Utrecht University, Utrecht, the Netherlands
| | - Caroline Ingre
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Peter Nilsson
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Sebastian A Lewandowski
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden. .,Department of Clinical Neuroscience, Karolinska Institute, Centre for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden.
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7
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Godelaine J, De Schaepdryver M, Bossuyt X, Van Damme P, Claeys KG, Poesen K. Prognostic value of neurofilament light chain in chronic inflammatory demyelinating polyneuropathy. Brain Commun 2021; 3:fcab018. [PMID: 33796853 PMCID: PMC7991223 DOI: 10.1093/braincomms/fcab018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/15/2020] [Accepted: 12/22/2020] [Indexed: 12/17/2022] Open
Abstract
Chronic inflammatory demyelinating polyneuropathy is a neuroinflammatory disorder with considerable variation in clinical phenotype, disease progression and therapy response among patients. Recently, paranodal antibodies associated with poor response to intravenous immunoglobulin therapy and more aggressive disease course have been described in small subsets of patients, but reliable serum-based prognostic biomarkers are not yet available for the general population. In current retrospective longitudinal study, we utilized logistic regression models to investigate the associations of serum neurofilament light chain levels with 1-year disease progression and therapy response during follow-up in chronic inflammatory demyelinating polyneuropathy. One-year disease progression was defined as a decrease of four or more points (the minimal clinically important difference) on an 80-point Medical Research Council sum-score scale 1 year after sampling. Patients who, compared to treatment received at time of sampling, required therapy switch during follow-up due to insufficient effect were classified as non-responders. Serum neurofilament light chain was measured by electrochemiluminescence assay in clinical residual serum samples of 76 patients diagnosed with probable (13 patients) or definite (63 patients) chronic inflammatory demyelinating polyneuropathy according to European Federation of Neurological Societies/Peripheral Nerve Society diagnostic criteria. Eleven (15%) patients were female, and the mean (standard deviation) cohort age was 61.5 (11.7) years. In both univariate and multivariable (including demographics) models, elevated serum neurofilament light chain harboured increased odds for 1-year disease progression (respectively odds ratio, 1.049; 95% confidence interval, 1.022-1.084 and odds ratio, 1.097; 95% confidence interval, 1.045-1.169; both P = 0.001). Patients with levels above the median cohort neurofilament light chain level (28.3 pg/ml) had largely increased odds of 1-year disease progression (univariate: odds ratio, 5.597; 95% confidence interval, 1.590-26.457; P = 0.01; multivariable: odds ratio, 6.572; 95% confidence interval, 1.495-39.702; P = 0.02) and of insufficient treatment response (univariate: odds ratio, 4.800; 95% confidence interval, 1.622-16.442; P = 0.007; multivariable: odds ratio, 6.441; 95% confidence interval, 1.749-29.357; P = 0.009). In a combined approach analysis, patients with levels above median cohort serum neurofilament light chain level reported strongly increased odds of demonstrating 1-year disease progression and/or therapy non-response during follow-up (univariate: odds ratio, 6.337; 95% confidence interval, 2.276-19.469; P < 0.001; multivariable: odds ratio, 10.138; 95% confidence interval, 2.801-46.404; P = 0.001). These results show that in various logistic regression models, serum neurofilament light chain was associated with both 1-year disease progression and therapy response during follow-up in chronic inflammatory demyelinating polyneuropathy. Hence, our findings warrant further prospective research regarding the value of neurofilament light chain as potential prognostic biomarker in chronic inflammatory demyelinating polyneuropathy.
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Affiliation(s)
- Joris Godelaine
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
| | - Maxim De Schaepdryver
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
| | - Xavier Bossuyt
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven 3000, Belgium
| | - Philip Van Damme
- Department of Neurology, University Hospitals Leuven, Leuven 3000, Belgium
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven 3000, Belgium
| | - Koen Poesen
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
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8
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De Vocht J, Blommaert J, Devrome M, Radwan A, Van Weehaeghe D, De Schaepdryver M, Ceccarini J, Rezaei A, Schramm G, van Aalst J, Chiò A, Pagani M, Stam D, Van Esch H, Lamaire N, Verhaegen M, Mertens N, Poesen K, van den Berg LH, van Es MA, Vandenberghe R, Vandenbulcke M, Van den Stock J, Koole M, Dupont P, Van Laere K, Van Damme P. Use of Multimodal Imaging and Clinical Biomarkers in Presymptomatic Carriers of C9orf72 Repeat Expansion. JAMA Neurol 2021; 77:1008-1017. [PMID: 32421156 PMCID: PMC7417970 DOI: 10.1001/jamaneurol.2020.1087] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Question Can metabolic brain changes be detected in presymptomatic individuals who are carriers of a hexanucleotide repeat expansion in the C9orf72 gene (preSxC9) using time-of-flight fluorine 18–labeled fluorodeoxyglucose positron emission tomographic imaging and magnetic resonance imaging, and what is the association between the mutation and clinical and fluid biomarkers of amyotrophic lateral sclerosis and frontotemporal dementia? Findings In a case-control study including 17 preSxC9 participants and 25 healthy controls, fluorine 18–labeled fluorodeoxyglucose positron emission tomographic imaging noted significant clusters of relative hypometabolism in frontotemporal regions, the insular cortices, basal ganglia, and thalami in the preSxC9 participants. Use of this strategy allowed detection of changes at an individual level. Meaning Glucose metabolic changes appear to occur early in the sequence of events leading to manifest amyotrophic lateral sclerosis and frontotemporal dementia. Fluorine 18–labeled fluorodeoxyglucose positron emission tomographic imaging may provide a sensitive biomarker of a presymptomatic phase of disease. Importance During a time with the potential for novel treatment strategies, early detection of disease manifestations at an individual level in presymptomatic carriers of a hexanucleotide repeat expansion in the C9orf72 gene (preSxC9) is becoming increasingly relevant. Objectives To evaluate changes in glucose metabolism before symptom onset of amyotrophic lateral sclerosis or frontotemporal dementia in preSxC9 using simultaneous fluorine 18–labeled fluorodeoxyglucose ([18F]FDG positron emission tomographic (PET) and magnetic resonance imaging as well as the mutation’s association with clinical and fluid biomarkers. Design, Setting, and Participants A prospective, case-control study enrolled 46 participants from November 30, 2015, until December 11, 2018. The study was conducted at the neuromuscular reference center of the University Hospitals Leuven, Leuven, Belgium. Main Outcomes and Measures Neuroimaging data were spatially normalized and analyzed at the voxel level at a height threshold of P < .001, cluster-level familywise error–corrected threshold of P < .05, and statistical significance was set at P < .05 for the volume-of-interest level analysis, using Benjamini-Hochberg correction for multiple correction. W-score maps were computed using the individuals serving as controls as a reference to quantify the degree of [18F]FDG PET abnormality. The threshold for abnormality on the W-score maps was designated as an absolute W-score greater than or equal to 1.96. Neurofilament levels and performance on cognitive and neurologic examinations were determined. All hypothesis tests were 1-sided. Results Of the 42 included participants, there were 17 with the preSxC9 mutation (12 women [71%]; mean [SD] age, 51 [9] years) and 25 healthy controls (12 women [48%]; mean [SD] age, 47 [10] years). Compared with control participants, significant clusters of relative hypometabolism were found in frontotemporal regions, basal ganglia, and thalami of preSxC9 participants and relative hypermetabolism in the peri-Rolandic region, superior frontal gyrus, and precuneus cortex. W-score frequency maps revealed reduced glucose metabolism with local maxima in the insular cortices, central opercular cortex, and thalami in up to 82% of preSxC9 participants and increased glucose metabolism in the precentral gyrus and precuneus cortex in up to 71% of preSxC9 participants. Other findings in the preSxC9 group were upper motor neuron involvement in 10 participants (59%), cognitive abnormalities in 5 participants (29%), and elevated neurofilament levels in 3 of 16 individuals (19%) who underwent lumbar puncture. Conclusions and Relevance The results suggest that [18F]FDG PET can identify glucose metabolic changes in preSxC9 at an individual level, preceding significantly elevated neurofilament levels and onset of symptoms.
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Affiliation(s)
- Joke De Vocht
- KU Leuven, Department of Neurosciences, Experimental Neurology, B-3000 Leuven, Belgium.,KU Leuven, University Hospitals Leuven, University Psychiatric Center, Adult Psychiatry, B-3000 Leuven, Belgium.,University Hospitals Leuven, Department of Neurology, B-3000 Leuven, Belgium.,VIB - Center of Brain & Disease Research, Laboratory of Neurobiology, B-3000 Leuven, Belgium
| | | | - Martijn Devrome
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - Ahmed Radwan
- KU Leuven, Department of Imaging and Pathology, Translational MRI, B-3000 Leuven, Belgium
| | - Donatienne Van Weehaeghe
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - Maxim De Schaepdryver
- KU Leuven, Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, B-3000 Leuven, Belgium
| | - Jenny Ceccarini
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - Ahmadreza Rezaei
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - Georg Schramm
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - June van Aalst
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - Adriano Chiò
- ALS Center, Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy.,Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Daphne Stam
- KU Leuven, Leuven Brain Institute, Laboratory for Translational Neuropsychiatry, B-3000 Leuven, Belgium
| | - Hilde Van Esch
- University Hospitals Leuven, Center for Human Genetics, B-3000 Leuven, Belgium
| | - Nikita Lamaire
- University Hospitals Leuven, Department of Neurology, B-3000 Leuven, Belgium
| | - Marianne Verhaegen
- KU Leuven, University Hospitals Leuven, University Psychiatric Center, Adult Psychiatry, B-3000 Leuven, Belgium
| | - Nathalie Mertens
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - Koen Poesen
- KU Leuven, Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, B-3000 Leuven, Belgium
| | - Leonard H van den Berg
- Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Michael A van Es
- Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rik Vandenberghe
- University Hospitals Leuven, Department of Neurology, B-3000 Leuven, Belgium.,KU Leuven, Department of Neurosciences, Laboratory for Cognitive Neurology, B-3000 Leuven, Belgium
| | - Mathieu Vandenbulcke
- KU Leuven, Leuven Brain Institute, Laboratory for Translational Neuropsychiatry, B-3000 Leuven, Belgium.,KU Leuven, University Psychiatric Center, Geriatric Psychiatry, B-3000 Leuven, Belgium
| | - Jan Van den Stock
- KU Leuven, Leuven Brain Institute, Laboratory for Translational Neuropsychiatry, B-3000 Leuven, Belgium.,KU Leuven, University Psychiatric Center, Geriatric Psychiatry, B-3000 Leuven, Belgium
| | - Michel Koole
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - Patrick Dupont
- KU Leuven, Department of Neurosciences, Laboratory for Cognitive Neurology, B-3000 Leuven, Belgium
| | - Koen Van Laere
- KU Leuven, University Hospitals Leuven, Department of Imaging and Pathology, Division of Nuclear Medicine, B-3000 Leuven, Belgium
| | - Philip Van Damme
- KU Leuven, Department of Neurosciences, Experimental Neurology, B-3000 Leuven, Belgium.,University Hospitals Leuven, Department of Neurology, B-3000 Leuven, Belgium.,VIB - Center of Brain & Disease Research, Laboratory of Neurobiology, B-3000 Leuven, Belgium
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9
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De Meyer S, Schaeverbeke JM, Verberk IMW, Gille B, De Schaepdryver M, Luckett ES, Gabel S, Bruffaerts R, Mauroo K, Thijssen EH, Stoops E, Vanderstichele HM, Teunissen CE, Vandenberghe R, Poesen K. Comparison of ELISA- and SIMOA-based quantification of plasma Aβ ratios for early detection of cerebral amyloidosis. Alzheimers Res Ther 2020; 12:162. [PMID: 33278904 PMCID: PMC7719262 DOI: 10.1186/s13195-020-00728-w] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/17/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Blood-based amyloid biomarkers may provide a non-invasive, cost-effective and scalable manner for detecting cerebral amyloidosis in early disease stages. METHODS In this prospective cross-sectional study, we quantified plasma Aβ1-42/Aβ1-40 ratios with both routinely available ELISAs and novel SIMOA Amyblood assays, and provided a head-to-head comparison of their performances to detect cerebral amyloidosis in a nondemented elderly cohort (n = 199). Participants were stratified according to amyloid-PET status, and the performance of plasma Aβ1-42/Aβ1-40 to detect cerebral amyloidosis was assessed using receiver operating characteristic analysis. We additionally investigated the correlations of plasma Aβ ratios with amyloid-PET and CSF Alzheimer's disease biomarkers, as well as platform agreement using Passing-Bablok regression and Bland-Altman analysis for both Aβ isoforms. RESULTS ELISA and SIMOA plasma Aβ1-42/Aβ1-40 detected cerebral amyloidosis with identical accuracy (ELISA: area under curve (AUC) 0.78, 95% CI 0.72-0.84; SIMOA: AUC 0.79, 95% CI 0.73-0.85), and both increased the performance of a basic demographic model including only age and APOE-ε4 genotype (p ≤ 0.02). ELISA and SIMOA had positive predictive values of respectively 41% and 36% in cognitively normal elderly and negative predictive values all exceeding 88%. Plasma Aβ1-42/Aβ1-40 correlated similarly with amyloid-PET for both platforms (Spearman ρ = - 0.32, p < 0.0001), yet correlations with CSF Aβ1-42/t-tau were stronger for ELISA (ρ = 0.41, p = 0.002) than for SIMOA (ρ = 0.29, p = 0.03). Plasma Aβ levels demonstrated poor agreement between ELISA and SIMOA with concentrations of both Aβ1-42 and Aβ1-40 measured by SIMOA consistently underestimating those measured by ELISA. CONCLUSIONS ELISA and SIMOA demonstrated equivalent performances in detecting cerebral amyloidosis through plasma Aβ1-42/Aβ1-40, both with high negative predictive values, making them equally suitable non-invasive prescreening tools for clinical trials by reducing the number of necessary PET scans for clinical trial recruitment. TRIAL REGISTRATION EudraCT 2009-014475-45 (registered on 23 Sept 2009) and EudraCT 2013-004671-12 (registered on 20 May 2014, https://www.clinicaltrialsregister.eu/ctr-search/trial/2013-004671-12/BE ).
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Affiliation(s)
- Steffi De Meyer
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, box 7003, Herestraat 49, 3000, Leuven, Belgium
- Laboratory Medicine, UZ Leuven, Leuven, Belgium
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Jolien M Schaeverbeke
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Inge M W Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Benjamin Gille
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, box 7003, Herestraat 49, 3000, Leuven, Belgium
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
| | - Maxim De Schaepdryver
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, box 7003, Herestraat 49, 3000, Leuven, Belgium
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
| | - Emma S Luckett
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Silvy Gabel
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Rose Bruffaerts
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Neurology Department, UZ Leuven, Leuven, Belgium
| | | | - Elisabeth H Thijssen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam UMC, Amsterdam, The Netherlands
| | | | | | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rik Vandenberghe
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Neurology Department, UZ Leuven, Leuven, Belgium
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, box 7003, Herestraat 49, 3000, Leuven, Belgium.
- Laboratory Medicine, UZ Leuven, Leuven, Belgium.
- Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium.
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Gray E, Oeckl P, Amador MDM, Andreasson U, An J, Blennow K, Bowser R, De Schaepdryver M, Heslegrave A, Kuhle J, Maceski A, Koel-Simmelink M, Lamari F, Lombardi V, Malaspina A, Nilsson I, Poesen K, Salachas F, Steinacker P, Teunissen CE, Van Damme P, Zetterberg H, Ludolph A, Jeromin A, Turner MR, Otto M. A multi-center study of neurofilament assay reliability and inter-laboratory variability. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:452-458. [PMID: 32558597 DOI: 10.1080/21678421.2020.1779300] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/21/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
Abstract
Objectives: Significantly elevated levels of neurofilament light chain (NfL) and phosphorylated neurofilament heavy chain (pNfH) have been described in the blood and cerebrospinal fluid (CSF) of amyotrophic lateral sclerosis (ALS) patients. The aim of this study was to evaluate the analytical performance of different neurofilament assays in a round robin with 10 centers across Europe/U.S. Methods: Serum, plasma and CSF samples from a group of five ALS and five neurological control patients were distributed across 10 international specialist neurochemical laboratories for analysis by a range of commercial and in-house neurofilament assays. The performance of all assays was evaluated for their ability to differentiate between the groups. The inter-assay coefficient of variation was calculated where appropriate from sample measurements performed across multiple laboratories using the same assay. Results: All assays could differentiate ALS patients from controls in CSF. Inter-assay coefficient of variation of analytical platforms performed across multiple laboratories varied between 6.5% and 41.9%. Conclusions: This study is encouraging for the growing momentum toward integration of neurofilament measurement into the specialized ALS clinic. It demonstrates the importance of 'round robin' studies necessary to ensure the analytical quality required for translation to the routine clinical setting. A standardized neurofilament probe is needed which can be used as international benchmark for analytical performance in ALS.
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Affiliation(s)
- Elizabeth Gray
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Patrick Oeckl
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Ulf Andreasson
- Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Jiyan An
- Iron Horse Diagnostics, Inc, Scottsdale, AZ, USA
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | | | - Maxim De Schaepdryver
- Laboratory for Molecular Neurobiomarker Research, University of Leuven, Leuven, Belgium
| | | | - Jens Kuhle
- University Hospital and University of Basel, Basel, Switzerland
| | | | - Marleen Koel-Simmelink
- Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam Neuroscience, Netherlands
| | | | | | | | - Irina Nilsson
- Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, University of Leuven, Leuven, Belgium
| | | | | | - Charlotte E Teunissen
- Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam Neuroscience, Netherlands
| | - Philip Van Damme
- Laboratory for Molecular Neurobiomarker Research, University of Leuven, Leuven, Belgium
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
- Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Albert Ludolph
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Martin R Turner
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
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11
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De Schaepdryver M, Lunetta C, Tarlarini C, Mosca L, Chio A, Van Damme P, Poesen K. Neurofilament light chain and C reactive protein explored as predictors of survival in amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2020; 91:436-437. [PMID: 32029541 DOI: 10.1136/jnnp-2019-322309] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Maxim De Schaepdryver
- Department of Neurosciences, Leuven Brain Institute, Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium
| | - Christian Lunetta
- NEuroMuscular Omnicenter (NEMO), Fondazione Serena Onlus, Milan, Italy
| | - Claudia Tarlarini
- NEuroMuscular Omnicenter (NEMO), Fondazione Serena Onlus, Milan, Italy
| | - Lorena Mosca
- Department of Laboratory Medicine, Medical Genetics Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Adriano Chio
- Department of Neuroscience, ALS Center 'Rita Levi Montalcini', University of Turin, Torino, Italy
| | - Philip Van Damme
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Department of Neurosciences, Leuven Brain Institute, Experimental Neurology, Laboratory of Neurobiology, VIB KU Leuven Center for Brain and Disease Research, Leuven, Belgium
| | - Koen Poesen
- Department of Neurosciences, Leuven Brain Institute, Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium .,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
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12
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Gille B, De Schaepdryver M, Dedeene L, Goossens J, Claeys KG, Van Den Bosch L, Tournoy J, Van Damme P, Poesen K. Inflammatory markers in cerebrospinal fluid: independent prognostic biomarkers in amyotrophic lateral sclerosis? J Neurol Neurosurg Psychiatry 2019; 90:1338-1346. [PMID: 31175169 DOI: 10.1136/jnnp-2018-319586] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 04/11/2019] [Accepted: 05/20/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Inflammation is a key pathological hallmark in amyotrophic lateral sclerosis (ALS), which seems to be linked to the disease progression. It is not clear what the added diagnostic and prognostic value are of inflammatory markers in the cerebrospinal fluid (CSF) of patients with ALS. METHODS Chitotriosidase-1 (CHIT1), chitinase-3-like protein 1 (YKL-40) and monocyte chemoattractant protein-1 (MCP-1) were measured in CSF and serum of patients with ALS (n=105), disease controls (n=102) and patients with a disease mimicking ALS (n=16). The discriminatory performance was evaluated by means of a receiver operating characteristic curve analysis. CSF and serum levels were correlated with several clinical parameters. A multivariate Cox regression analysis, including eight other established prognostic markers, was used to evaluate survival in ALS. RESULTS In CSF, CHIT1, YKL-40 and MCP-1 showed a weak discriminatory performance between ALS and ALS mimics (area under the curve: 0.79, p<0.0001; 0.72, p=0.001; 0.75, p=0.001, respectively). CHIT1 and YKL-40 correlated with the disease progression rate (ρ=0.28, p=0.009; ρ=0.34, p=0.002, respectively). CHIT1 levels were elevated in patients with a higher number of regions displaying motor neuron degeneration (one vs three regions: 4248 vs 13 518 pg/mL, p = 0.0075). In CSF, YKL-40 and MCP-1 were independently associated with survival (HR: 29.7, p=0.0003; 6.14, p=0.001, respectively). CONCLUSIONS Our findings show that inflammation in patients with ALS reflects the disease progression as an independent predictor of survival. Our data encourage the use of inflammatory markers in patient stratification and as surrogate markers of therapy response in clinical trials.
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Affiliation(s)
- Benjamin Gille
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium.,Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Maxim De Schaepdryver
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Lieselot Dedeene
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Janne Goossens
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium
| | - Kristl G Claeys
- Department of Neurology, Neuromuscular Reference Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Neurosciences, Laboratory for Muscle Diseases and Neuropathies, KU Leuven, Leuven, Belgium
| | - Ludo Van Den Bosch
- Department of Neurosciences, Laboratory of Neurobiology, KU Leuven, Leuven, Belgium.,VIB, Center for Brain & Disease Research, KU Leuven, Leuven, Belgium
| | - Jos Tournoy
- Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium.,Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Philip Van Damme
- Department of Neurology, Neuromuscular Reference Centre, University Hospitals Leuven, Leuven, Belgium.,VIB, Center for Brain & Disease Research, KU Leuven, Leuven, Belgium
| | - Koen Poesen
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium .,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
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De Schaepdryver M, Goossens J, De Meyer S, Jeromin A, Masrori P, Brix B, Claeys KG, Schaeverbeke J, Adamczuk K, Vandenberghe R, Van Damme P, Poesen K. Serum neurofilament heavy chains as early marker of motor neuron degeneration. Ann Clin Transl Neurol 2019; 6:1971-1979. [PMID: 31518073 PMCID: PMC6801162 DOI: 10.1002/acn3.50890] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/13/2019] [Accepted: 08/19/2019] [Indexed: 12/12/2022] Open
Abstract
Objective To determine whether serum phosphorylated neurofilament heavy chain (pNfH) levels are elevated before patients were diagnosed with sporadic or familial ALS, and what the prognostic value of these prediagnostic pNfH levels is. Methods pNfH was measured via ELISA in leftovers of serum drawn for routine purposes before the time of diagnosis. These prediagnostic samples were retrieved from the biobank of the University Hospitals Leuven for 95 patients who in follow‐up received a diagnosis of ALS. Additionally, 35 patients with mild cognitive impairment (MCI) and 85 healthy controls (HC) were included in this retrospective study. Results The median disease duration (range) from onset to prediagnostic sampling and from onset to diagnosis was 6.5 (−71.9–36.1) and 9.9 (2.0–40.7) months, respectively. Fifty‐eight percent of the prediagnostic samples had serum pNfH levels above the 95th percentile of pNfH levels measured in HC. Serum pNfH levels (median (range)) were elevated up to 18 months before the diagnosis of ALS (91 pg/mL (6–342 pg/mL)) in comparison with HC (30 pg/mL (6–146 pg/mL); P = 0.05), and increased during the prediagnostic stage, which was not observed in patients with MCI. Furthermore, prediagnostic pNfH levels were a univariate predictor of survival in ALS (hazard ratio (95% CI): 2.16 (1.20–3.87); P = 0.01). Interpretation Our findings demonstrate that serum pNfH is elevated well before the time of diagnosis in mainly sporadic ALS patients. These results encourage to prospectively explore if pNfH has an added value to shorten the diagnostic delay in ALS.
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Affiliation(s)
- Maxim De Schaepdryver
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Janne Goossens
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Steffi De Meyer
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - Pegah Masrori
- Laboratory of Neurobiology, Center for Brain & Disease Research, VIB, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Experimental Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - Kristl G Claeys
- Laboratory for Muscle diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Jolien Schaeverbeke
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Katarzyna Adamczuk
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Rik Vandenberghe
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Philip Van Damme
- Laboratory of Neurobiology, Center for Brain & Disease Research, VIB, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Experimental Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
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De Schaepdryver M, Goossens J, Jeromin A, Brix B, Van Damme P, Poesen K. Analytical performance of a CE-marked immunoassay to quantify phosphorylated neurofilament heavy chains. Clin Chem Lab Med 2019; 57:e199-e202. [PMID: 30710472 DOI: 10.1515/cclm-2018-1004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/16/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Maxim De Schaepdryver
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven (University of Leuven), Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Janne Goossens
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven (University of Leuven), Leuven, Belgium
| | | | | | - Philip Van Damme
- Department of Neurosciences, Laboratory of Neurobiology, KU Leuven (University of Leuven) and Center for Brain and Disease Research VIB Leuven, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Koen Poesen
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven (University of Leuven), Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
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De Schaepdryver M, Jeromin A, Gille B, Claeys KG, Herbst V, Brix B, Van Damme P, Poesen K. Comparison of elevated phosphorylated neurofilament heavy chains in serum and cerebrospinal fluid of patients with amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2018; 89:367-373. [PMID: 29054919 DOI: 10.1136/jnnp-2017-316605] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Phosphorylated neurofilament heavy chain (pNfH) levels are elevated in cerebrospinal fluid (CSF) of patients with amyotrophic lateral sclerosis (ALS). Instead of CSF, we explored blood as an alternative source to measure pNfH in patients with ALS. METHODS In this single centre retrospective study, 85 patients with ALS, 215 disease controls (DC) and 31 ALS mimics were included. Individual serum pNfH concentrations were correlated with concentrations in CSF and with several clinical parameters. The performance characteristics of pNfH in CSF and serum of patients with ALS and controls were calculated and compared using receiver operating characteristic (ROC) curves. RESULTS CSF and serum pNfH concentrations in patients with ALS correlated well (r=0.652, p<0.0001) and were significantly increased compared with DC (p<0.0001) and ALS mimics (p<0.0001). CSF pNfH outperformed serum pNfH in discriminating patients with ALS from DC and ALS mimics (difference between area under the ROC curves: p=0.0001 and p=0.0005; respectively). Serum pNfH correlated inversely with symptom duration (r=-0.315, p=0.0033). CSF and serum pNfH were lower when the disease progression rate was slower (r=0.279, p<0.01 and r=0.289, p<0.01; respectively). Unlike CSF, serum pNfH did not correlate with the burden of clinical and electromyographic motor neuron dysfunction. CONCLUSIONS CSF and serum pNfH concentrations are elevated in patients with ALS and correlate with the disease progression rate. Moreover, CSF pNfH correlates with the burden of motor neuron dysfunction. Our findings encourage further pursuit of CSF and serum pNfH concentrations in the diagnostic pathway of patients suspected to have ALS.
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Affiliation(s)
- Maxim De Schaepdryver
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven (University of Leuven), Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Benjamin Gille
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven (University of Leuven), Leuven, Belgium
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Department of Neurosciences, Laboratory for Muscle diseases and Neuropathies, KU Leuven (University of Leuven), Leuven, Belgium
| | | | | | - Philip Van Damme
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Department of Neurosciences, KU Leuven (University of Leuven) and Center for Brain & Disease Research VIB Leuven, Leuven, Belgium
| | - Koen Poesen
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven (University of Leuven), Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
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Gille B, Dedeene L, Stoops E, Demeyer L, Francois C, Lefever S, De Schaepdryver M, Brix B, Vandenberghe R, Tournoy J, Vanderstichele H, Poesen K. Automation on an Open-Access Platform of Alzheimer's Disease Biomarker Immunoassays. SLAS Technol 2018; 23:188-197. [PMID: 29346009 DOI: 10.1177/2472630317750378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The lack of (inter-)laboratory standardization has hampered the application of universal cutoff values for Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers and their transfer to general clinical practice. The automation of the AD biomarker immunoassays is suggested to generate more robust results than using manual testing. Open-access platforms will facilitate the integration of automation for novel biomarkers, allowing the introduction of the protein profiling concept. A feasibility study was performed on an automated open-access platform of the commercial immunoassays for the 42-amino-acid isoform of amyloid-β (Aβ1-42), Aβ1-40, and total tau in CSF. Automated Aβ1-42, Aβ1-40, and tau immunoassays were performed within predefined acceptance criteria for bias and imprecision. Similar accuracy was obtained for ready-to-use calibrators as for reconstituted lyophilized kit calibrators. When compared with the addition of a standard curve in each test run, the use of a master calibrator curve, determined before and applied to each batch analysis as the standard curve, yielded an acceptable overall bias of -2.6% and -0.9% for Aβ1-42 and Aβ1-40, respectively, with an imprecision profile of 6.2% and 8.4%, respectively. Our findings show that transfer of commercial manual immunoassays to fully automated open-access platforms is feasible, as it performs according to universal acceptance criteria.
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Affiliation(s)
- Benjamin Gille
- 1 Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium.,2 Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Lieselot Dedeene
- 1 Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | | | | | - Stefanie Lefever
- 1 Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Maxim De Schaepdryver
- 1 Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium.,4 Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Rik Vandenberghe
- 6 Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,7 Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium.,8 Alzheimer Research Centre KU Leuven, Leuven Institute of Neuroscience and Disease, Leuven, Belgium
| | - Jos Tournoy
- 2 Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium.,8 Alzheimer Research Centre KU Leuven, Leuven Institute of Neuroscience and Disease, Leuven, Belgium.,9 Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | | | - Koen Poesen
- 1 Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, Leuven, Belgium.,4 Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
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17
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Poesen K, De Schaepdryver M, Stubendorff B, Gille B, Muckova P, Wendler S, Prell T, Ringer TM, Rhode H, Stevens O, Claeys KG, Couwelier G, D'Hondt A, Lamaire N, Tilkin P, Van Reijen D, Gourmaud S, Fedtke N, Heiling B, Rumpel M, Rödiger A, Gunkel A, Witte OW, Paquet C, Vandenberghe R, Grosskreutz J, Van Damme P. Neurofilament markers for ALS correlate with extent of upper and lower motor neuron disease. Neurology 2017; 88:2302-2309. [PMID: 28500227 DOI: 10.1212/wnl.0000000000004029] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 03/21/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the diagnostic performance and prognostic value of phosphorylated neurofilament heavy chain (pNfH) and neurofilament light chain (NfL) in CSF as possible biomarkers for amyotrophic lateral sclerosis (ALS) at the diagnostic phase. METHODS We measured CSF pNfH and NfL concentrations in 220 patients with ALS, 316 neurologic disease controls (DC), and 50 genuine disease mimics (DM) to determine and assess the accuracy of the diagnostic cutoff value for pNfH and NfL and to correlate with other clinical parameters. RESULTS pNfH was most specific for motor neuron disease (specificity 88.2% [confidence interval (CI) 83.0%-92.3%]). pNfH had the best performance to differentially diagnose patients with ALS from DM with a sensitivity of 90.7% (CI 84.9%-94.8%), a specificity of 88.0% (CI 75.7%-95.5%) and a likelihood ratio of 7.6 (CI 3.6-16.0) at a cutoff of 768 pg/mL. CSF pNfH and NfL levels were significantly lower in slow disease progressors, however, with a poor prognostic performance with respect to the disease progression rate. CSF pNfH and NfL levels increased significantly as function of the number of regions with both upper and lower motor involvement. CONCLUSIONS In particular, CSF pNfH concentrations show an added value as diagnostic biomarkers for ALS, whereas the prognostic value of pNfH and NfL warrants further investigation. Both pNfH and NfL correlated with the extent of motor neuron degeneration. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that elevated concentrations of CSF pNfH and NfL can accurately identify patients with ALS.
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Affiliation(s)
- Koen Poesen
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France.
| | - Maxim De Schaepdryver
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Beatrice Stubendorff
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Benjamin Gille
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Petra Muckova
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Sindy Wendler
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Tino Prell
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Thomas M Ringer
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Heidrun Rhode
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Olivier Stevens
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Kristl G Claeys
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Goedele Couwelier
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Ann D'Hondt
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Nikita Lamaire
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Petra Tilkin
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Dimphna Van Reijen
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Sarah Gourmaud
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Nadin Fedtke
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Bianka Heiling
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Matthias Rumpel
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Annekathrin Rödiger
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Anne Gunkel
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Otto W Witte
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Claire Paquet
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Rik Vandenberghe
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Julian Grosskreutz
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
| | - Philip Van Damme
- From the Laboratory for Molecular Neurobiomarker Research (K.P., M.D.S., B.G.), Laboratory for Cognitive Neurology (R.V.) and Laboratory of Neurobiology (Center for Brain & Disease Research, VIB, Leuven) (P.V.D.), Department of Neurosciences, KU Leuven (University of Leuven); Laboratory Medicine (K.P., M.D.S.) and Department of Neurology (O.S., K.G.C., G.C., A.D., N.L., P.T., D.V.R., R.V., P.V.D.), University Hospitals Leuven, Belgium; Hans Berger Department of Neurology (B.S., T.P., T.M.R., N.F., B.H., M.R., A.R., A.G., O.W.W., J.G.) and Institute for Biochemistry (P.M., S.W., H.R.), Jena University Hospital, Germany; INSERM, U942 (S.G., C.P.), Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, CMRR Paris Nord AP-HP, Université Paris Diderot, France
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