CSF neurofilament light chain and tau differentiate multiple system atrophy from Parkinson's disease.
BACKGROUND
In early disease stages it can be clinically difficult to differentiate idiopathic Parkinson's disease (IPD) from patients with multiple system atrophy predominated by parkinsonism (MSA-P).


METHODS
In CSF of 31 patients with IPD, 19 patients with MSA-P, we analyzed tau, neurofilament light chain (NFL) and heavy chain (NFHp35) and the noradrenergic metabolite 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG).


RESULTS
CSF levels of NFL, NFHp35, and tau were significantly increased in MSA-P (all p<0.0001), whereas, MHPG levels were significantly decreased in MSA-P (p<0.0001). Optimal discriminative cut-off values for the differentiation between MSA-P and IPD were calculated resulting in high sensitivity (76-94%) and specificity (83-97%) levels. Multivariate logistic regression resulted in the combination of NFL and tau as independent contributors in differentiating between MSA-P and IPD.


CONCLUSIONS
Higher CSF levels of axonal biomarkers could reflect advanced axonal degeneration in MSA-P. Differentiating MSA-P from IPD could be accurately possible with CSF analysis of a combination of axonal and neurotransmitter biomarkers.
Abdo
W Farid
WF
Department of Neurology, Radboud University, Nijmegen Medical Centre, The Netherlands. f.abdo@neuro.umcn.nl
Bloem
Bastiaan R
BR
Van Geel
Wieneke J
WJ
Esselink
Rianne A J
RA
Verbeek
Marcel M
MM