Multifocal motor neuropathy as a mimic of amyotrophic lateral sclerosis: Serum neurofilament light chain as a reliable diagnostic biomarker.

Autor: Kleinveld VEA; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Keritam O; Department of Neurology, Medical University of Vienna, Vienna, Austria.; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria., Horlings CGC; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Cetin H; Department of Neurology, Medical University of Vienna, Vienna, Austria.; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria., Wanschitz J; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Hotter A; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Zirch LS; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Zimprich F; Department of Neurology, Medical University of Vienna, Vienna, Austria., Topakian R; Department of Neurology, Academic Teaching Hospital Wels-Grieskirchen, Wels, Austria.; Klinisches Forschungsinstitut Neurowissenschaften, Johannes Kepler UniversitätLinz, Linz, Austria., Müller P; Department of Neurology, Academic Teaching Hospital Wels-Grieskirchen, Wels, Austria., Oel D; Department of Neurology, Academic Teaching Hospital Wels-Grieskirchen, Wels, Austria., Quasthoff S; Department of Neurology, Medical University of Graz, Graz, Austria., Erdler M; Department of Neurology, Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Vienna, Austria., Rauschka H; Department of Neurology, Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Vienna, Austria., Grinzinger S; Department of Neurology, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria., Jecel J; Department of Neurology, KH Hietzing, Vienna, Austria., Gaulhofer P; Department of Neurology, LKH Graz 2, Graz, Austria., Castek B; Department of Neurology, LKH Villach, Villach, Austria., Stadler K; Private Practice Neurology, Wels, Austria., Löscher WN; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Jazyk: angličtina
Zdroj: Muscle & nerve [Muscle Nerve] 2024 Apr; Vol. 69 (4), pp. 422-427. Date of Electronic Publication: 2024 Feb 09.
DOI: 10.1002/mus.28054
Abstrakt: Introduction/aims: The clinical presentation of multifocal motor neuropathy (MMN) may mimic early amyotrophic lateral sclerosis (ALS) with predominant lower motor neuron (LMN) involvement, posing a diagnostic challenge. Both diseases have specific treatments and prognoses, highlighting the importance of early diagnosis. The aim of this study was to assess the diagnostic value of serum neurofilament light chain (NfL) in differentiating MMN from LMN dominant ALS.
Methods: NfL was measured in serum in n = 37 patients with MMN and n = 37 age- and sex-matched patients with LMN dominant ALS, to determine the diagnostic accuracy. Clinical and demographic data were obtained at the time of NfL sampling.
Results: Serum NfL concentration was significantly lower in MMN patients compared to ALS patients (mean 20.7 pg/mL vs. 59.4 pg/mL, p < .01). NfL demonstrated good diagnostic value in discriminating the two groups (AUC 0.985 [95% CI 0.963-1.000], sensitivity 94.6%, specificity 100%, cut-off 44.00 pg/mL).
Discussion: NfL could be a helpful tool in differentiating MMN from LMN dominant ALS in those patients in whom electrophysiological and clinical examinations remain inconclusive early in the diagnostic process.
(© 2024 The Authors. Muscle & Nerve published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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