Clinical use and reporting of neurofilament quantification in neurological disorders: A global overview
Constance Delaby, Aurélie Ladang, Jose Martinez‐Yriarte, Chiara Zecca, Giancarlo Logroscino, Péter Körtvelyessy, Hayrettin Tumani, Piero Parchi, Isabelle Quadrio, Melanie Hart, Dorte Aalund Olsen, Daniel Alcolea, Kaj Blennow, Juan Fortea, Alberto Lleó, Alicia Algeciras‐Schimnich, Xavier Ayrignac, Aurélie Bedel, Gustavo Alves Andrade dos Santos, Wyllians Vendramini Borelli, Élodie Bouaziz-Amar, Inês Baldeiras, Edith Bigot‐Corbel, Maria Bjerke, Mercedes Carretero Perez, Tiziana Casoli, Tinatin Chabrashvili, Miles Chapman, Jessica Cusato, Erdinç Dursun, Anthony Fourier, Daniela Galimberti, Duygu Gezen‐Ak, Brian A. Gordon, Julien Gouju, Silvia de las Heras Flórez, Juanjo Hernandez Sanchez, Marina Herwerth, Daniele Imperiale, Flora Kaczorowski, Kensaku Kasuga, Ashvini Keshavan, Michael Khalil, Jens Kühle, Christoph Leithner, Piotr Lewczuk, Franck Letournel, Magda Tsolaki, Guido Maria Giuffrè, M Blanc, Barbara Mroczko, Jose Enrique Martínez Rodríguez, Giulia Musso, Agnieszka Kulczyńska‐Przybik, Léonor Nogueira, Claire Paquet, Simone Baiardi, Lorenzo Gaetani, Lucilla Parnetti, Raquel Perez Garay, Koen Poesen, Muriel Quillard‐Muraine, Enrique Rodriguez Borja, Susanna Schraen, Daniela Terracciano, Franziska Bachhuber, Steffen Halbgebauer, Socrates J. Tzartos, John Tzartos, Nadine Unterwalder, Lisa Vermunt, Cheryl L. Wellington, Henrik Zetterberg, Charlotte E. Teunissen, Sylvain Lehmann
Abstract
INTRODUCTION: Neurofilament light chain (NfL) quantification aids in diagnosing and predicting neurological disorders, but clinical and laboratory practices vary across centers. Differences in result interpretation and reporting further challenge test commutability. This study aimed to review the global analytical and post-analytical methods used for NfL measurement in routine clinical practice across different contexts. METHODS: We established an international working group (WG) and distributed a survey to its members to gather information on context of use (COU), (pre) analytical methods, cutoff usage, as well as the interpretation and reporting of NfL measurements. RESULTS: Among the centers, 63% measured NfL in cerebrospinal fluid (CSF), 87% in blood, and 53% in both. COU was widespread, with 50% defining pathological cutoffs based on publications and 42% considering age. Reporting was primarily done through numeric results (95%). DISCUSSION: Harmonizing cutoffs, reporting, and interpretation across various clinical contexts will facilitate the incorporation of this biomarker into routine clinical practice. HIGHLIGHTS: Unique international overview of current analytical and post-analytical methods for neurofilament light chain (NfL) measurement in routine clinical practice. Tailored sheets for each neurological application. Strategies to harmonize cutoffs, reporting, and interpretation of NfL's measurement.