Serum neurofilament dynamics predicts neurodegeneration in presymptomatic Alzheimer’s

[Islander]

Serum neurofilament dynamics predicts neurodegeneration and clinical progression in presymptomatic Alzheimer’s disease

• Oliver Preische,
• Stephanie A. Schultz,
• […]
• Dominantly Inherited Alzheimer Network

Nature Medicinevolume 25, pages 277–283(2019)

Abstract
Neurofilament light chain (NfL) is a promising fluid biomarker of disease progression for various cerebral proteopathies. Here we leverage the unique characteristics of the Dominantly Inherited Alzheimer Network and ultrasensitive immunoassay technology to demonstrate that NfL levels in the cerebrospinal fluid (n?=?187) and serum (n?=?405) are correlated with one another and are elevated at the presymptomatic stages of familial Alzheimer’s disease. Longitudinal, within-person analysis of serum NfL dynamics (n?=?196) confirmed this elevation and further revealed that the rate of change of serum NfL could discriminate mutation carriers from non-mutation carriers almost a decade earlier than cross-sectional absolute NfL levels (that is, 16.2 versus 6.8 years before the estimated symptom onset).

Keep reading: https://www.nature.com/articles/s41591-018-0304-3

[Islander]

In simpler language, incipient Alzheimer's may now be predicted up to seven years before it becomes symptomatic. Here is a slightly more readable report:
https://alzres.biomedcentral.com/art...195-018-0404-9

[Julieanne]

My ex had Alzheimer's, and I think my son is concerned he might inherit it - but I'm not sure he wants to know. I think his view is that it is incurable, so how would it help to know now?

[Mr. Wizard]

Julieanne, I share your son's view. However, I read recently about a joint effort between the National Institutes of Health and Eli Lily pharmaceutical to develop a drug to stop Alzheimer's "before it starts" in high risk people. It's called the "A4 Study: Stopping Alzheimer's Before Symptoms Begin" Read: What is the A4 Study: https://a4study.org/about/

Read more here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049292/

[Julieanne]

Thanks Mr Wiz, I'll send him the link - up to him if he wants to read it. Are there tests to show if you are at risk?

[Mr. Wizard]

Yes, there are tests for people who are "genetic-at-risk" and/or "age-at-risk." Genetic testing will determine if a person has "risk" genes, like APOE-e4 gene, and/or "deterministic" genes. Risk genes just means you have increased likelihood, but does not guarantee you will develop the disease. Deterministic genes directly cause the disease. **The Alzheimer's Association strongly recommends consulting a "genetic counselor" before getting tested. Gene testing provides limited, sometimes confusing, information that needs to be interpreted by an expert. As for age-at-risk testing, a positron emission tomography or PET imaging scan will show if there's an accumulation of amyloid plaque buildup in the brain. While amyloid plaque does not cause Alz, it is associated with the disease. It is believed that amyloid plaque begins accumulating in the brain a decade or more before any signs of cognitive decline begin to appear. This is what the A4 study is about...it is evaluating people who have shown amyloid buildup, but no signs of cognitive decline. The idea is to develop a drug to begin treating the brain before it begins to show cognitive decline. Your son may benefit from reading about the pros and cons of genetic testing at: https://www.alz.org/blog/alz/april_2...heimer_s_disea

[Julieanne]

Thanks again. You are always a mine of information!