Contributions
Abstract: 11
Type: Educational Session
Abstract Category: N/A
Neurofilament Light (NfL) reflects axonal damage in the brain and is elevated in almost all neurological diseases. Importantly, blood levels of NfL correlate strongly with CSF NfL levels, and there is strong evidence that NfL in blood (serum/plasma) can identify patients with neurological damage similarly as previously shown for CSF. The possibility of blood analysis opens opportunities to establish neurological damage in groups for which CSF would not be available, i.e. outside the hospital setting and when monitoring of disease activity is required.
Now that it is possible to objectively measure the effect of traumatic events on brain damage, the wish is to implement the NfL blood test in these multiple fields of medicine, e.g. to support decision making by neurologists, and e.g. sports doctors, and impact patient management. However, important steps need to be taken for implementation. For example, results should be harmonised among centers, which can be achieved by large multicentre comparison studies and establishment of an international quality control program. In addition, reference methods and material need to be developed, in order to calibrate tests to generate comparable results. In addition, it is relevant to define pre-analytical factors that may cause significant variation in results, such as life-style factors, comorbidities, or variation in sample processing. Another important issue is to establish reference values, i.e. values in the normal population, or in clinically relevant populations in case of differential diagnosis. In light of the latter, it will be relevant to adjust the reporting to these clinical question. Lastly, reimbursement should be settled.
Overall, there is strong promise in NfL as a generic tool for monitoring neurological damage, but implementation requires still that important preparative steps are taken.
Disclosure: Prof Teunissen is co-leading a multicenter NfL evaluation study which is sponsored by Quanterix.
Abstract: 11
Type: Educational Session
Abstract Category: N/A
Neurofilament Light (NfL) reflects axonal damage in the brain and is elevated in almost all neurological diseases. Importantly, blood levels of NfL correlate strongly with CSF NfL levels, and there is strong evidence that NfL in blood (serum/plasma) can identify patients with neurological damage similarly as previously shown for CSF. The possibility of blood analysis opens opportunities to establish neurological damage in groups for which CSF would not be available, i.e. outside the hospital setting and when monitoring of disease activity is required.
Now that it is possible to objectively measure the effect of traumatic events on brain damage, the wish is to implement the NfL blood test in these multiple fields of medicine, e.g. to support decision making by neurologists, and e.g. sports doctors, and impact patient management. However, important steps need to be taken for implementation. For example, results should be harmonised among centers, which can be achieved by large multicentre comparison studies and establishment of an international quality control program. In addition, reference methods and material need to be developed, in order to calibrate tests to generate comparable results. In addition, it is relevant to define pre-analytical factors that may cause significant variation in results, such as life-style factors, comorbidities, or variation in sample processing. Another important issue is to establish reference values, i.e. values in the normal population, or in clinically relevant populations in case of differential diagnosis. In light of the latter, it will be relevant to adjust the reporting to these clinical question. Lastly, reimbursement should be settled.
Overall, there is strong promise in NfL as a generic tool for monitoring neurological damage, but implementation requires still that important preparative steps are taken.
Disclosure: Prof Teunissen is co-leading a multicenter NfL evaluation study which is sponsored by Quanterix.