Serum neurofilament light (NfL)

Serum neurofilament light (NfL), a marker of neuronal injury.



NfL is associated with multiple sclerosis (MS) disability, brain atrophy, and disease activity.



Among nearly 7,000 MS patients, those with elevated serum NfL had worse walking speed, manual dexterity, and processing speed; lower whole brain and thalamic volumes; and higher number of gadolinium-enhancing lesions.



Serum NfL is a marker of axonal damage and is not specific to MS, and diabetes, smoking, and BMI may affect its levels. 



NfL is a 68 kDa cytoskeletal intermediate filament protein that is expressed in neurons. 



It associates with Neurofilament medium (NfM) and Neurofilament heavy (NfH) to form neurofilaments. 



They are major components of the neuronal cytoskeleton, and are believed to function primarily to provide structural support for the axon and to regulate axon diameter. 



Neurofilaments can be released in significant quantity following axonal damage or neuronal degeneration. 



Increased NfL levels associated with traumatic brain injury, multiple sclerosis, frontotemporal dementia and other neurodegenerative diseases. 



The Simoa NF-light assay is a digital immunoassay for the quantitative determination of NfL in serum, plasma and CSF. 



17.2% off MS patients, 17.2%, have elevated serum NfL. 



Elevated NfL levels sen in progressive MS, non-white race, diabetes, and smoking status.



Age and symptom duration in MS showed complex associations with serum NfL status.



Highest frequency of elevated NfL is  seen in younger patients with shorter disease duration of M.S.



Higher BMI was associated with lower odds of elevated serum NfL.




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