TitleCSF neurofilament light chain and phosphorylated tau 181 predict disease progression in PSP.
Publication TypeJournal Article
Year of Publication2018
AuthorsRojas JC, Bang J, Lobach IV, Tsai RM, Rabinovici GD, Miller BL, Boxer AL
Corporate AuthorsAL-108-231 investigators
Date Published2018 Jan 23

OBJECTIVE: To determine the ability of CSF biomarkers to predict disease progression in progressive supranuclear palsy (PSP).

METHODS: We compared the ability of baseline CSF β-amyloid, tau, phosphorylated tau 181 (p-tau), and neurofilament light chain (NfL) concentrations, measured by INNO-BIA AlzBio3 or ELISA, to predict 52-week changes in clinical (PSP Rating Scale [PSPRS] and Schwab and England Activities of Daily Living [SEADL]), neuropsychological, and regional brain volumes on MRI using linear mixed effects models controlled for age, sex, and baseline disease severity, and Fisher density curves to compare effect sizes in 50 patients with PSP. Similar analyses were done using plasma NfL measured by single molecule arrays in 141 patients.

RESULTS: Higher CSF NfL concentration predicted more rapid decline (biomarker × time interaction) over 52 weeks in PSPRS ( = 0.004, false discovery rate-corrected) and SEADL ( = 0.008), whereas lower baseline CSF p-tau predicted faster decline on PSPRS ( = 0.004). Higher CSF tau concentrations predicted faster decline by SEADL ( = 0.004). The CSF NfL/p-tau ratio was superior for predicting change in PSPRS, compared to p-tau ( = 0.003) or NfL ( = 0.001) alone. Higher NfL concentrations in CSF or blood were associated with greater superior cerebellar peduncle atrophy (fixed effect, ≤ 0.029 and 0.008, respectively).

CONCLUSIONS: Both CSF p-tau and NfL correlate with disease severity and rate of disease progression in PSP. The inverse correlation of p-tau with disease severity suggests a potentially different mechanism of tau pathology in PSP as compared to Alzheimer disease.

Alternate JournalNeurology
PubMed ID29282336
PubMed Central IDPMC5798651
Grant ListP01 AG019724 / AG / NIA NIH HHS / United States
P50 AG023501 / AG / NIA NIH HHS / United States
U54 NS092089 / NS / NINDS NIH HHS / United States