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@ARTICLE{Muccioli:281826,
author = {Muccioli, Lorenzo and Ganceviciute, Bazile and Becker,
Felicitas and Minardi, Raffaella and Tappatà, Maria and
Bachhuber, Franziska and Alkhatib, Mahmoud and Cirak,
Sebahattin and Weishaupt, Jochen H and Verma, Mayank and
Tumani, Hayrettin and Wagner, Jan and Messahel, Souad and
Nitschke, Felix and Minassian, Berge A and Bisulli,
Francesca and Brenner, David},
title = {{N}eurofilament {L}ight {C}hain as a {B}iomarker of
{D}isease {P}rogression in {L}afora {D}isease.},
journal = {Neurology / Genetics},
volume = {11},
number = {6},
issn = {2376-7839},
address = {Minneapolis, Minn.},
publisher = {[Verlag nicht ermittelbar]},
reportid = {DZNE-2025-01207},
pages = {e200319},
year = {2025},
abstract = {Lafora disease (LD) is a severe, ultra-rare childhood-onset
progressive myoclonus epilepsy caused by biallelic
pathogenic variants in either EPM2A or NHLRC1 and currently
without cure. Body fluid-derived biomarkers have remained
largely unexplored in LD. Neurofilament light chain (NfL)
levels in serum (sNfL) and CSF (cNfL) reflect ongoing
neurodegeneration and have been established as prognostic
and therapeutic biomarkers in various neurologic disorders.
In this study, we assessed the utility of NfL as a biomarker
of LD in a multicenter cohort of patients with LD.We
conducted cross-sectional and longitudinal measurements of
NfL levels in serum (n = 32) and CSF (n = 25) samples from a
cohort of 31 patients with LD (26 independent families; mean
age 21 years; age range 10.2-40.3; f:m = 16:15; EPM2A:NHLRC1
= 16:15) at diverse disease stages (median LD stage 2) and
age-matched control participants with transient minor
neurologic conditions (mean age 21.9 years; age range
11.1-41.3; f:m 22:8), treated at 3 referral centers in Ulm,
Bologna, and Dallas. At each visit, we assessed LD stage
(median LD stage 2; range 0-4) and LD clinical performance
score (median score 10.5; range 0-18), allowing for
correlation with NfL measurements.When compared with control
participants (mean sNfL 7.72, $95\%$ CI 6.79-8.65; mean cNfL
306.8, $95\%$ CI 251.5-362.2), CSF and serum NfL levels were
increased in patients with LD (mean sNfL 13.95, $95\%$ CI
11.20-16.69; mean cNfL 576.9, $95\%$ CI 465.3-688.5). cNfL
values exhibited less variability than sNfL, resulting in
superior discriminatory performance between those with LD
and controls in receiver operating characteristic (ROC)
analyses (AUC sNfL = 0.80; cNfL = 0.88). NfL levels tended
to increase longitudinally when samples had been collected
≥12 months after baseline. sNfL levels correlated with
both disease stage (r = 0.56) and LD Clinical Performance
Scale score (r = -0.49), but not with disease duration
(owing to genotype-dependent clinical heterogeneity).Our
findings support the utility of NfL, particularly sNfL, as a
promising biomarker of disease progression in LD. While
further research is needed to fully elucidate the potential
of NfL in this context, it holds immediate promise as an
exploratory outcome measure in ongoing and future clinical
trials.},
cin = {Clinical Study Center (Ulm)},
ddc = {610},
cid = {I:(DE-2719)5000077},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41143127},
pmc = {pmc:PMC12552056},
doi = {10.1212/NXG.0000000000200319},
url = {https://pub.dzne.de/record/281826},
}