Correlation between plasma neurofilament light chain and subtypes of Parkinson disease
Objective To investigate the correlation between plasma total α-synuclein(α-syn),phosphorylated α-synuclein(p-α-syn),neurofilament light chain(NfL)and subtypes of Parkinson disease(PD).Methods A total of 62 PD patients admitted to the Department of Neurology,the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from September 2021 to January 2023 were selected and scored on the Hoehn-Yahr stage(H-Y),unified Parkinson's disease rating scale Ⅲ(UPDRS-Ⅲ),levo-dopa equivalent daily dosage(LEDD),mini-mental state examination(MMSE),Parkinson disease quality of life questionnaire(PDQ-39)and activities of daily living(ADL).During the same period,25 healthy indi-viduals matched in age and sex were enrolled as the control group(HC).Clinical characteristics and blood samples were collected.The plasma levels of α-syn,p-α-syn and NfL were detected by enzyme-linked immu-nosorbent assay(ELISA).PD patients were divided into tremor dominant type(TD,n=27)and akinetic-rig-id dominant type(AR,n=35)based on UPDRS-Ⅲ scores.Multifactorial Logistic regression analysis was performed by SPSS 25.0 software to determine the influencing factors of subtypes of Parkinson disease.The receiver operating characteristic(ROC)curve was used to determine the optimal cut-off point of plasma NfL between the AR type and the TD type.Results Plasma α-syn,p-α-syn,NfL levels in the PD group were significantly higher than those of the HC group(Z=-2.537,-6.580,-7.101,all P＜0.05).There were sta-tistically significant differences between the AR type and the TD type in disease duration,H-Y stage,UPDRS-Ⅲ scores,LEDD and MMSE scores(Z=-2.503,-3.021,-2.025,-2.086,-2.409,all P＜0.05).While no significant difference was found in plasma α-syn and p-α-syn levels between the AR type and TD type(Z=-0.341,-0.085,both P＞0.05),the plasma NfL levels were notably higher in the AR type(92.79(16.84,117.53)pg/mL)compared to the TD type(12.10(6.99,100.17)pg/mL)(Z=-2.236,P＜0.05).Plasma NfL levels were correlated with rigidity scores(r=0.438,P＜0.001),UPDRS-Ⅲ scores(r=0.337,P＜0.05)and motor subtypes(r=0.286,P＜0.05)in PD patients.Multivariate Logistic regression a-nalysis showed that NfL was risk factor for AR(B=0.002,OR=1.002,95％CI=1.001-1.003,P=0.017).The ROC curve analysis indicated that plasma NfL levels could predict different subtypes of PD with an AUC=0.667,optimal cutoff=26.527.Conclusion There is a correlation between elevated plasma NfL levels and the occurrence of AR type of PD,suggesting that nerve injury is probably involved in the occurrence and progression of various motor subtypes of PD.
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