% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Lindenborn:285205,
      author       = {Lindenborn, Paula and Fabian, Rachel and Grehl, Torsten and
                      Nazlican, Huelya and Meyer, Thomas and Bernsen, Sarah and
                      Weydt, Patrick},
      title        = {{C}ombination of {S}erum {N}eurofilament {L}ight {C}hain
                      and {S}erum {C}ardiac {T}roponin {T} as {B}iomarkers
                      {I}mproves {D}iagnostic {A}ccuracy in {A}myotrophic
                      {L}ateral {S}clerosis.},
      journal      = {Annals of neurology},
      volume       = {99},
      number       = {2},
      issn         = {0364-5134},
      address      = {Hoboken, NJ},
      publisher    = {Wiley-Blackwell},
      reportid     = {DZNE-2026-00184},
      pages        = {408 - 417},
      year         = {2026},
      abstract     = {We aimed to evaluate the clinical utility of serum
                      neurofilament light chain (sNfL) and cardiac troponin T
                      (cTnT) in amyotrophic lateral sclerosis (ALS) and assess
                      whether their combination improves diagnostic accuracy.We
                      retrospectively analyzed 293 ALS patients, 85
                      neurodegenerative disease controls, and 29 healthy controls.
                      A validation cohort of 501 ALS patients was analyzed to
                      confirm reproducibility of the results. Receiver operating
                      characteristic (ROC) curve analysis was performed for sNfL,
                      cTnT, and their combination, and the area under the curve
                      (AUC) was compared across groups. An ALS-specific cTnT
                      cut-off of 8.35ng/L was determined using the Youden index
                      and applied in subgroup analyses, in which
                      'biomarker-negative' ALS patients were compared to
                      'biomarker-positive' patients regarding disease duration and
                      progression.sNfL showed excellent performance in
                      discriminating ALS patients from healthy controls (AUC =
                      0.94), but only moderate performance in discriminating
                      neurodegenerative disease controls (AUC = 0.82). Combining
                      sNfL and cTnT improved diagnostic accuracy for ALS over
                      neurodegenerative controls, with an AUC of 0.90, whereas
                      cTnT alone showed an AUC of 0.77. The validation cohort
                      showed similar AUCs. 'Biomarker-negative' ALS patients had a
                      longer disease duration (73.0 vs 18.0 months, p = 0.0003)
                      and a lower progression rate (0.19 vs 0.70 points per
                      months, p < 0.0001) than 'biomarker-positive'
                      patients.Although sNfL alone performs well in distinguishing
                      ALS from healthy controls, repurposing cTnT for ALS provides
                      additional value in discriminating ALS from disease
                      controls. The combination of sNfL and cTnT improves
                      diagnostic accuracy and may help identify prognostically
                      distinct ALS subgroups. ANN NEUROL 2026;99:408-417.},
      cin          = {Clinical Research (Bonn) / AG Radbruch},
      ddc          = {610},
      cid          = {I:(DE-2719)1011001 / I:(DE-2719)5000075},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41133969},
      doi          = {10.1002/ana.78066},
      url          = {https://pub.dzne.de/record/285205},
}