Research Article| Volume 367, P269-274, August 15, 2016

Phosphorylated neurofilament heavy chain levels in paired plasma and CSF of amyotrophic lateral sclerosis


      • pNF-H of ALS in Asian
      • Paired plasma and CSF pNF-H
      • pNF-H has a correlation with TTG.


      Background and objective

      Amyotrophic lateral sclerosis (ALS) is a fatal disease characterized by degeneration of both upper and lower motor neurons. In this study, we aimed to measure both plasma and cerebrospinal fluid (CSF) phosphorylated neurofilament heavy chain (pNF-H) levels in patients with ALS, and determine if there is a correlation. We also evaluated plasma and CSF pNF-H levels to investigate if this biomarker could predict the time to generalization (TTG) in ALS better.


      Paired plasma and CSF pNF-H levels of patients with ALS (n = 51), multiple system atrophy (n = 12) and controls (n = 30) were measured by monoclonal sandwich ELISA. TTG, which also indicates the time of symptoms spreading from spinal or bulbar localization to both, was evaluated in all ALS patients.


      We found a strong correlation between plasma and CSF pNF-H levels within individual patients (r = 0.712, p < 0.001). The mean TTG in ALS patients was 22.9 months (range 1–84 months), and there was an inverse correlation between plasma (r = −0.661; p < 0.001)/CSF (r = −0.869; p < 0.001) pNF-H levels and TTG.


      The correlation of plasma and CSF pNF-H levels would bring insight into the pathogenesis of ALS. TTG might play an important role in the future study of ALS, as an early indicator of survival.


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