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Sökning: onr:"swepub:oai:lup.lub.lu.se:70da2537-9e8b-4207-b633-70cf614c4533" > Cerebrospinal fluid...

Cerebrospinal fluid neurofilament light chain differentiates behavioural variant frontotemporal dementia progressors from non-progressors

Eratne, Dhamidhu (författare)
University of Melbourne,Royal Melbourne Hospital
Keem, Michael (författare)
Royal Melbourne Hospital,University of Melbourne
Lewis, Courtney (författare)
University of Melbourne,Royal Melbourne Hospital
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Kang, Matthew (författare)
Royal Melbourne Hospital,University of Melbourne
Walterfang, Mark (författare)
University of Melbourne,Royal Melbourne Hospital,The Florey Institute of Neuroscience and Mental Health
Farrand, Sarah (författare)
University of Melbourne,Royal Melbourne Hospital
Loi, Samantha (författare)
Royal Melbourne Hospital,University of Melbourne
Kelso, Wendy (författare)
Royal Melbourne Hospital
Cadwallader, Claire (författare)
Royal Melbourne Hospital
Berkovic, Samuel F. (författare)
University of Melbourne
Li, Qiao Xin (författare)
The Florey Institute of Neuroscience and Mental Health
Masters, Colin L. (författare)
The Florey Institute of Neuroscience and Mental Health
Collins, Steven (författare)
The Florey Institute of Neuroscience and Mental Health
Santillo, Alexander (författare)
Lund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,Clinical Memory Research,Lund University Research Groups
Velakoulis, Dennis (författare)
Royal Melbourne Hospital,University of Melbourne
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 (creator_code:org_t)
 
Elsevier BV, 2022
2022
Engelska.
Ingår i: Journal of the Neurological Sciences. - : Elsevier BV. - 0022-510X. ; 442
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background: Distinguishing behavioural variant frontotemporal dementia (bvFTD) from non-neurodegenerative ‘non-progressor’ mimics of frontal lobe dysfunction, can be one of the most challenging clinical dilemmas. A biomarker of neuronal injury, neurofilament light chain (NfL), could reduce misdiagnosis and delay. Methods: Cerebrospinal fluid (CSF) NfL, amyloid beta 1–42 (AB42), total and phosphorylated tau (T-tau, P-tau) levels were examined in patients with an initial diagnosis of bvFTD. Based on follow-up information, patients were categorised as Progressors or Non-Progressors: further subtyped into Non-Progressor Revised (non-neurological/neurodegenerative final diagnosis), and Non-Progressor Static (static deficits, not fully explained by non-neurological/neurodegenerative causes). Results: Forty-three patients were included: 20 Progressors, 23 Non-Progressors (15 Non-Progressor Revised, 8 Non-Progressor Static), and 20 controls. NfL concentrations were lower in Non-Progressors (Non-Progressors Mean, M = 554 pg/mL, 95%CI:[461, 675], Non-Progressor Revised M = 459 pg/mL, 95%CI:[385, 539], and Non-Progressor Static M = 730 pg/mL, 95%CI:[516, 940]), compared to Progressors (M = 2397 pg/mL, 95%CI:[1607, 3332]). NfL distinguished Progressors from Non-Progressors with the highest accuracy (area under the curve 0.92, 90%/87% sensitivity/specificity, 86%/91% positive/negative predictive value, 88% accuracy). Non-Progressor Static tended to have higher T-tau and P-tau levels compared to Non-Progressor Revised Diagnoses. Conclusion: This study demonstrated strong diagnostic utility of CSF NfL to distinguish bvFTD from non-progressor variants, at baseline, with high accuracy, in a real-world clinical setting. This has important clinical implications, to improve outcomes for patients and clinicians facing this challenging clinical dilemma, healthcare services, and clinical trials. Further research is required to investigate heterogeneity within the non-progressor group and potential diagnostic algorithms, and prospective studies are underway assessing plasma NfL.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Nyckelord

Behavioural variant frontotemporal dementia
Diagnosis
Neurofilament
Non-progressor
Phenocopy
Psychiatric

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