Plasma NfL levels as a potential biomarker in MCI and Alzheimer’s disease

Giulia Giacomucci, MD, University of Florence, Florence, Italy, describes her team’s work on evaluating neurofilament light chain (NfL) levels as a potential biomarker in patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer’s disease (AD). In a study of 110 patients, it was shown that plasma NfL levels differed between these groups and were notably higher in MCI and AD, compared to in SCD patients. The most interesting result was that plasma NfL levels depended on amyloid beta (Aβ) pathology, exemplified by MCI carriers of Aβ pathology (+) presenting with higher NfL levels than MCI non-carriers of Aβ pathology (-). Other findings included that the levels of NfL was similar in MCI+ and AD patients, and similar between SCD+ and MCI-. From this, one can hypothesize that NfL levels demonstrate the dynamics of AD, whereby limited neural death occurs in SCD, a peak of neuronal death is reached, and consequently, neuronal death plateaus at the dementia phase. Overall, the NfL levels were influenced by cognitive status and Aβ pathology, therefore, Dr Giacomucci thinks that plasma NfL levels might be a promising biomarker of preclinical neurodegenerative phases of the AD continuum. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.
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