Neurofilament Light Chain, Serum

CPT: 83520
Updated on 10/26/2022
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Special Instructions

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

This assay is currently not available in New York state.

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.<>

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.


Expected Turnaround Time

1 - 3 days

1 - 3 days

1 - 3 days

1 - 3 days

1 - 3 days


Related Documents


Specimen Requirements


Specimen

Serum


Volume

1 mL


Minimum Volume

0.7 mL (Note: This volume does not allow for repeat testing.)


Container

Red-top tube, gel-barrier tube


Collection

If a red-top tube is used, transfer separated serum to a plastic transport tube.


Storage Instructions

Room temperature


Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3


Test Details


Use

Assessing neuronal damage related to various neurodegenerative diseases


Limitations

This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

There are significant variations in measured serum NfL levels among different methods and labs. Care must be taken when interpreting results obtained in different studies.

Direct comparisons of absolute values can only be done on the same source fluid (plasma or serum).9

A rise in NfL is not specific for a specific disease factor and may be caused by both neurodegenerative diseases or a head impact during sports. Results should only be used in conjunction with other clinical information when evaluating patients with neurodegeneration. Due to a lack of specificity to a particular neurodegenerative disease, its role as a diagnostic marker is limited.

There are numerous demographic, life style, and comorbidity factors that potentially influence NfL levels in serum. Variables such as exercise,76 blood volume, body mass index may impact measured serum NfL levels.

NfL levels measured in the morning are more than 10% higher than those measured in the evening.11,77

Caution should be taken in interpreting NfL levels when disease treatment induced neurological complications that can potentially impact NfL levels.28,78

Serum NfL levels can be decreased in patients with high immunoglobulin G (IgG) levels.


Methodology

Roche Diagnostics Electrochemiluminescence Immunoassay (ECLIA)


Reference Interval

See table.

Age (y)

Male (pg/mL)

Female (pg/mL)

0 to 4 y

<1.97

<1.97

5 to 9 y

<1.64

<1.64

10 to 14 y

<1.43

<1.43

15 to 19 y

<1.60

<1.60

20 to 29 y

<1.65

<1.65

30 to 39 y

<1.88

<1.88

40 to 49 y

<2.14

<2.14

50 to 59 y

<3.79

<3.79

60 to 69 y

<4.62

<4.62

70 to 79 y

<7.65

<7.65

>79 y

<11.56

<11.56


Additional Information

Neurofilament proteins are protein polymers measuring 10 nm in diameter and many micrometers in length that, together with microtubules and microfilaments, form the neuronal cytoskeleton.1,2 These proteins are also prominent components of abnormal intra-neuronal aggregates in varied neurodegenerative diseases, including multiple sclerosis (MS), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD) and Huntington disease (HD).3 Neurofilament light chain (NfL) is constantly released from neurons into the extracellular space and ultimately reaches the cerebrospinal fluid (CSF) under physiological conditions. CSF NfL concentrations can increase in neurodegeneration and neuronal injury across a wide range of neurologic diseases. Serum NfL (sNfL) levels in healthy individuals are about 2.5% of the levels in CSF and correlate highly with the concentrations in CSF.4-9 sNfL levels rise above normal in response to neuronal injury and neurodegeneration independent of cause.10

sNfL levels are increased in early relapsing multiple sclerosis (MS) and have been shown to correlate with markers of disease severity.4,11-20 In some reports, sNfL has been able to detect MS disease activity earlier than routine MRI21 and before clinical MS onset of disease.13,22,23 In patients with confirmed relapsing or progressive MS, sNfL can predict short-term outcomes including clinical and cognitive performance4,13,18,24 as well as predicting long-term worsening and risk of developing progressive MS.25 Treatment with disease modifying therapy has been reported to be associated with lower sNfL levels compared to untreated individuals.4,13,14,21,26,27 Increased sNfL levels can indicate neurotoxicity after hematopoietic stem cell transplant in multiple sclerosis.28

The application of sNfL as a potential biomarker for Alzheimer's disease (AD) has been extensively investigated.3,5,29-36 sNfL levels have been shown to be higher in patients with mild cognitive impairment and patients with AD compared with healthy controls.37,38 Moreover, higher sNfL levels have been associated with cognitive decline in non-dementia older adults.39 Elevated NfL levels have been associated with the presence of amyloid-beta plaques in pre-symptomatic individuals and with the load of tau in symptomatic patients.33 Increased sNfL levels have also been associated with AD progression independent of amyloid-beta.40 sNfL levels have been shown to correlate with Braak staging in AD41 and normal sNfL levels have been linked with resistance to PS1 familial AD in apolipoprotein E3 (APOE3) Christchurch mutation.42

In amyotrophic lateral sclerosis (ALS), elevated sNfL levels have been observed up to 3.5 years before symptom onset with the extent to which the elevation of NfL occurs prior to symptoms related to the specific gene mutation causing the disease.43,44 Levels of NfL have been shown to have excellent diagnostic and prognostic performance for symptomatic patients with ALS.45-49

sNfL levels reflect cortical neurodegeneration from the very early stages of Parkinson's disease (PD) and have been shown to track the underlying pathological process leading to PD dementia.12,50-56 Higher baseline NfL levels were also associated with greater motor and cognitive decline after a follow-up period of 3 years in patients with PD.12,51,52 sNfL levels correlated with disease severity and levels reflect cortical neurodegeneration from the very early stages of PD.51 In advanced PD patients, sNfL concentrations are associated with motor function, cognitive decline and subclinical cardiac damage.57

In HD, sNfL levels were significantly higher in patients than in healthy controls and significantly higher in manifest HD than pre-manifest HD.58-60 Increased sNfL levels were found in young adult carriers of HD gene mutation approximately 24 years before the clinical onset of symptoms.61

In frontotemporal dementia (FD), sNfL levels were found to be significantly higher than in healthy controls with the elevations correlating with disease severity.62 Increased sNfL levels were observed 1 to 2 years before the clinical onset of symptoms in patients with FD.63 In patients diagnosed with dementia with Lewy bodies (DLB), sNfL levels were found to be about 2-fold higher than in healthy controls with the elevations correlating with disease severity.64 sNfL levels were found to be a superior predictor of cognitive decline compared to age, sex and baseline severity variables in DLB.64 In patients with Charcot-Marie-Tooth neuropathy, sNfL levels were about 2-fold higher in patients than in healthy controls and levels correlated with disease severity.65-67 sNfL levels were also found to be significantly elevated in acquired peripheral neuropathy with levels that correlated not only with disease severity but also with outcome.68 sNfL levels also declined with remission.69

Increased levels of sNfL have been reported in patients with traumatic brain injury (TBI).70-74 sNfL levels are higher in all patients suffering from concussion compared to healthy controls. Sports-related concussion has specifically been associated with higher levels of sNfL.74

In the acute and post-acute phase after stroke, high sNfL levels are associated with poor clinical outcome and positively correlate with secondary neurodegeneration as assessed by MRI.75


Footnotes

1. Yuan A, Nixon RA. Neurofilament Proteins as Biomarkers to Monitor Neurological Diseases and the Efficacy of Therapies. Front Neurosci. 2021 Sep 27;15:689938.34646114
2. Yuan A, Rao MV, Veeranna, Nixon RA. Neurofilaments and Neurofilament Proteins in Health and Disease. Cold Spring Harb Perspect Biol. 2017 Apr;9(4):a018309.28373358
3. Khalil M, Teunissen CE, Otto M, et al. Neurofilaments as biomarkers in neurological disorders. Nat Rev Neurol. 2018 Oct;14(10):577-589.30171200
4. Disanto G, Barro C, Benkert P, et al. Serum Neurofilament light: A biomarker of neuronal damage in multiple sclerosis. Ann Neurol. 2017 Jun;81(6):857-870.28512753
5. Pereira JB, Westman E, Hansson O, Alzheimer's Disease Neuroimaging Initiative. Association between cerebrospinal fluid and plasma neurodegeneration biomarkers with brain atrophy in Alzheimer's disease. Neurobiol Aging. 2017 Oct;58:14-29.28692877
6. Khalil M, Pirpamer L, Hofer E, et al. Serum neurofilament light levels in normal aging and their association with morphologic brain changes. Nat Commun. 2020 Feb 10;11(1):812.32041951
7. Alagaratnam J, von Widekind S, De Francesco D, et al. Correlation between CSF and blood neurofilament light chain protein: a systematic review and meta-analysis. BMJ Neurol Open. 2021 Jun 16;3(1):e000143.34223154
8. Gisslén M, Price RW, Andreasson U, et al. Plasma Concentration of the Neurofilament Light Protein (NFL) is a Biomarker of CNS Injury in HIV Infection: A Cross-Sectional Study. EBioMedicine. 2015 Nov 22;3:135-140.26870824
9. Hviid CVB, Knudsen CS, Parkner T. Reference interval and preanalytical properties of serum neurofilament light chain in Scandinavian adults. Scand J Clin Lab Invest. 2020 Jul;80(4):291-295.32077769
10. Barro C, Chitnis T, Weiner HL. Blood neurofilament light: a critical review of its application to neurologic disease. Ann Clin Transl Neurol. 2020 Dec;7(12):2508-2523.33146954
11. Thebault S, Booth RA, Rush CA, MacLean H, Freedman MS. Serum Neurofilament Light Chain Measurement in MS: Hurdles to Clinical Translation. Front Neurosci. 2021 Mar 25;15:654942.33841093
12. Ma LZ, Zhang C, Wang H, et al. Serum Neurofilament Dynamics Predicts Cognitive Progression in de novo Parkinson's Disease. J Parkinsons Dis. 2021;11(3):1117-1127.33935105
13. Bittner S, Oh J, Havrdová EK, Tintoré M, Zipp F. The potential of serum neurofilament as biomarker for multiple sclerosis. Brain. 2021 Nov 29;144(10):2954-2963.34180982
14. Kuhle J, Kropshofer H, Haering DA, et al. Blood neurofilament light chain as a biomarker of MS disease activity and treatment response. Neurology. 2019 Mar 5;92(10):e1007-e1015.30737333
15. Novakova L, Zetterberg H, Sundström P, et al. Monitoring disease activity in multiple sclerosis using serum neurofilament light protein. Neurology. 2017 Nov 28;89(22):2230-2237.29079686
16. Kuhle J, Barro C, Disanto G, et al. Serum neurofilament light chain in early relapsing remitting MS is increased and correlates with CSF levels and with MRI measures of disease severity. Mult Scler. 2016 Oct;22(12):1550-1559.26754800
17. Szilasiová J, Mikula P, Rosenberger J, et al. Plasma neurofilament light chain levels are predictors of disease activity in multiple sclerosis as measured by four-domain NEDA status, including brain volume loss. Mult Scler. 2021 Nov;27(13):2023-2030.33635154
18. Jakimovski D, Kuhle J, Ramanathan M, et al. Serum neurofilament light chain levels associations with gray matter pathology: a 5-year longitudinal study. Ann Clin Transl Neurol. 2019 Sep;6(9):1757-1770.31437387
19. Benkert P, Meier S, Schaedelin S, et al. Serum neurofilament light chain for individual prognostication of disease activity in people with multiple sclerosis: a retrospective modelling and validation study. Lancet Neurol. 2022 Mar;21(3):246-257.35182510
20. Valentino P, Marnetto F, Martire S, et al. Serum neurofilament light chain levels in healthy individuals: A proposal of cut-off values for use in multiple sclerosis clinical practice. Mult Scler Relat Disord. 2021 Sep;54:103090.34182224
21. Akgün K, Kretschmann N, Haase R, et al. Profiling individual clinical responses by high-frequency serum neurofilament assessment in MS. Neurol Neuroimmunol Neuroinflamm. 2019 Apr 8;6(3):e555.31119188
22. Bjornevik K, Munger KL, Cortese M, et al. Serum Neurofilament Light Chain Levels in Patients With Presymptomatic Multiple Sclerosis. JAMA Neurol. 2020 Jan 1;77(1):58-64.31515562
23. van der Vuurst de Vries RM, Wong YYM, Mescheriakova JY, et al. High neurofilament levels are associated with clinically definite multiple sclerosis in children and adults with clinically isolated syndrome. Mult Scler. 2019 Jun;25(7):958-967.29774770
24. Filippi P, Vestenická V, Siarnik P, et al. Neurofilament light chain and MRI volume parameters as markers of neurodegeneration in multiple sclerosis. Neuro Endocrinol Lett. 2020 Apr;41(1):17-26.32338853
25. Thebault S, Abdoli M, Fereshtehnejad SM, Terssier D, Tabard-Cossa V, Freedman MS. Serum neurofilament light chain predicts long term clinical outcomes in multiple sclerosis. Sci Rep. 2020 Jun 25;10(1):10381.32587320
26. Calabresi PA, Arnold DL, Sangurdekar D, et al. Temporal profile of serum neurofilament light in multiple sclerosis: Implications for patient monitoring. Mult Scler. 2021 Sep;27(10):1497-1505.33307998
27. Harris S, Comi G, Cree BAC, et al. Plasma neurofilament light chain concentrations as a biomarker of clinical and radiologic outcomes in relapsing multiple sclerosis: Post hoc analysis of Phase 3 ozanimod trials. Eur J Neurol. 2021 Nov;28(11):3722-3730.34292643
28. Thebault S, Lee H, Bose G, et al. Neurotoxicity after hematopoietic stem cell transplant in multiple sclerosis. Ann Clin Transl Neurol. 2020 May;7(5):767-775.32304358
29. Olsson B, Lautner R, Andreasson U, et al. CSF and blood biomarkers for the diagnosis of Alzheimer's disease: a systematic review and meta-analysis. Lancet Neurol. 2016 Jun;15(7):673-684.27068280
30. Bridel C, van Wieringen WN, Zetterberg H, et al. Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology: A Systematic Review and Meta-analysis. JAMA Neurol. 2019 Sep 1;76(9):1035-1048.31206160
31. Jin M, Cao L, Dai YP. Role of Neurofilament Light Chain as a Potential Biomarker for Alzheimer's Disease: A Correlative Meta-Analysis. Front Aging Neurosci. 2019;11:254.31572170
32. Preische O, Schultz SA, Apel A, et al. Serum neurofilament dynamics predicts neurodegeneration and clinical progression in presymptomatic Alzheimer's disease. Nat Med. 2019 Feb;25(2):277-283.30664784
33. Benedet AL, Leuzy A, Pascoal TA, et al. Stage-specific links between plasma neurofilament light and imaging biomarkers of Alzheimer's disease. Brain. 2020;143(12):3793-3804.33210117
34. Sugarman MA, Zetterberg H, Blennow K, et al. A longitudinal examination of plasma neurofilament light and total tau for the clinical detection and monitoring of Alzheimer's disease. Neurobiol Aging. 2020 Oct;94:60-70.32585491
35. Santangelo R, Agosta F, Masi F, et al. Plasma neurofilament light chain levels and cognitive testing as predictors of fast progression in Alzheimer's disease. Eur J Neurol. 2021 Sep;28(9):2980-2988.34176186
36. Li D, Zhang L, Nelson NW, Mielke MM, Yu F. Plasma Neurofilament Light and Future Declines in Cognition and Function in Alzheimer's Disease in the FIT-AD Trial. J Alzheimers Dis Rep. 2021 Jul 21;5(1):601-611.34514342
37. Mattsson N, Andreasson U, Zetterberg H, Blennow K, Alzheimer’s Disease Neuroimaging Initiative. Association of Plasma Neurofilament Light with Neurodegeneration in Patients with Alzheimer Disease. JAMA Neurol. 2017 May 1;74(5):557-566.28346578
38. Zhou W, Zhang J, Ye F, et al. Plasma neurofilament light chain levels in Alzheimer's disease. Neurosci Lett. 2017 May 22;650:60-64.28428015
39. He L, Morley JE, Aggarwal G, et al. Plasma neurofilament light chain is associated with cognitive decline in non-dementia older adults. Sci Rep. 2021 Jun 28;11(1):13394.34183688
40. Moscoso A, Grothe MJ, Ashton NJ, et al. Longitudinal Associations of Blood Phosphorylated Tau181 and Neurofilament Light Chain with Neurodegeneration in Alzheimer Disease. JAMA Neurol. 2021 Apr 1;78(4):396-406.33427873
41. Ashton NJ, Leuzy A, Lim YM, et al. Increased plasma neurofilament light chain concentration correlates with severity of post-mortem neurofibrillary tangle pathology and neurodegeneration. Acta Neuropathol Commun. 2019 Jan 9;7(1):5.30626432
42. Arboleda-Velasquez JF, Lopera F, O'Hare M, et al. Resistance to autosomal dominant Alzheimer's disease in an APOE3 Christchurch homozygote: a case report. Nat Med. 2019 Nov;25(11):1680-1683.31686034
43. Benatar M, Wuu J, Andersen PM, Lombardi V, Malaspina A. Neurofilament light: A candidate biomarker of presymptomatic amyotrophic lateral sclerosis and phenoconversion. Ann Neurol. 2018 Jul;84(1):130-139.30014505
44. Benatar M, Wuu J, Lombardi V, et al. Neurofilaments in pre-symptomatic ALS and the impact of genotype. Amyotroph Lateral Scler Frontotemporal Degener. 2019 Nov;20(7-8):538-548.31432691
45. Brettschneider J, Petzold A, Süssmuth SD, Ludolph AC, Tumani H. Axonal damage markers in cerebrospinal fluid are increased in ALS. Neurology. 2006 Mar 28;66(6):852-856.16567701
46. Zetterberg H, Jacobsson J, Rosengren L, Blennow K, Andersen PM. Cerebrospinal fluid neurofilament light levels in amyotrophic lateral sclerosis: impact of SOD1 genotype. Eur J Neurol. 2007 Dec;14(12):1329-1333.17903209
47. Lu CH, Macdonald-Wallis C, Gray E, et al. Neurofilament light chain: A prognostic biomarker in amyotrophic lateral sclerosis. Neurology. 2015 Jun 2;84(22):2247-2257.25934855
48. Thouvenot E, Demattei C, Lehmann S, et al. Serum neurofilament light chain at time of diagnosis is an independent prognostic factor of survival in amyotrophic lateral sclerosis. Eur J Neurol. 2020 Feb;27(2):251-257.31437330
49. Vacchiano V, Mastrangelo A, Zenesini C, et al. Plasma and CSF Neurofilament Light Chain in Amyotrophic Lateral Sclerosis: A Cross-Sectional and Longitudinal Study. Front Aging Neurosci. 2021 Oct 22;13:753242.34744694
50. Sampedro F, Pérez-González R, Martínez-Horta J, Marín-Lahoz J, Pagonabarraga J, Kulisevsky J. Serum neurofilament light chain levels reflect cortical neurodegeneration in de novo Parkinson's disease. Parkinsonism Relat Disord. 2020 May;74:43-49.32334380
51. Lin CH, Li CH, Yang KC, et al. Blood NfL: A biomarker for disease severity and progression in Parkinson disease. Neurology. 2019 Sep 10;93(11):e1104-e1111.31420461
52. Zhu Y, Yang B, Wang F, et al. Association between plasma neurofilament light chain levels and cognitive function in patients with Parkinson's disease. J Neuroimmunol. 2021 Sep 15;358:577662.34311152
53. Ye R, Locascio JJ, Goodheart AE, Quan M, Zhang B, Gomperts SN. Serum NFL levels predict progression of motor impairment and reduction in putamen dopamine transporter binding ratios in de novo Parkinson's disease: An 8-year longitudinal study. Parkinsonism Relat Disord. 2021 Apr;85:11-16.33639572
54. Parkin GM, Corey-Bloom J, Snell C, Castelon J, Thomas EA. Plasma neurofilament light in Huntington's disease: A marker for disease onset, but not symptom progression. Parkinsonism Relat Disord. 2021 Jun;87:32-38.33940564
55. Hansson O, Janelidze S, Hall S, et al. Blood-based NfL: A biomarker for differential diagnosis of parkinsonian disorder. Neurology. 2017 Mar 7;88(10):930-937.28179466
56. Parkin GM, Corey-Bloom J, Long JD, Snell C, Smith H, Thomas EA. Associations between prognostic index scores and plasma neurofilament light in Huntington's disease. Parkinsonism Relat Disord. 2022 Apr;97:25-28.35276585
57. Niemann L, Lezius S, Maceski A, et al. Serum neurofilament is associated with motor function, cognitive decline and subclinical cardiac damage in advanced Parkinson's disease (MARK-PD). Parkinsonism Relat Disord. 2021 Sep;90:44-48.34352610
58. Byrne LM, Rodrigues FB, Blennow K, et al. Neurofilament light protein in blood as a potential biomarker of neurodegeneration in Huntington's disease: a retrospective cohort analysis. Lancet Neurol. 2017 Aug;16(8):601-609.28601473
59. Byrne LM, Rodrigues FB, Johnson EB, et al. Evaluation of mutant huntingtin and neurofilament proteins as potential markers in Huntington's disease. Sci Transl Med. 2018 Sep 12;10(458):eaat7108.30209243
60. Rodrigues FB, Byrne LM, Tortelli R, et al. Mutant huntingtin and neurofilament light have distinct longitudinal dynamics in Huntington's disease. Sci Transl Med. 2020 Dec 16;12(574):eabc2888.33328328
61. Scahill RI, Zeun P, Osborne-Crowley K, et al. Biological and clinical characteristics of gene carriers far from predicted onset in the Huntington's disease Young Adult Study (HD-YAS): a cross-sectional analysis. Lancet Neurol. 2020 Jun;19(6):502-512.32470422
62. Rohrer JD, Woollacott IO, Dick KM, et al. Serum neurofilament light chain protein is a measure of disease intensity in frontotemporal dementia. Neurology. 2016 Sep 27;87(13):1329-1336.27581216
63. van der Ende EL, Meeter LH, Poos JM, et al. Serum neurofilament light chain in genetic frontotemporal dementia: a longitudinal, multicentre cohort study. Lancet Neurol. 2019 Dec;18(12):1103-1111.31701893
64. Pilotto A, Imarisio A, Carrarini C, et al. Plasma Neurofilament Light Chain Predicts Cognitive Progression in Prodromal and Clinical Dementia with Lewy Bodies. J Alzheimers Dis. 2021;82(3):913-919.34151807
65. Sandelius Å, Zetterberg H, Blennow K, et al. Plasma neurofilament light chain concentration in the inherited peripheral neuropathies. Neurology. 2018 Feb 6;90(6):e518-e524.29321234
66. Millere E, Rots D, Simrén J, et al. Plasma neurofilament light chain as a potential biomarker in Charcot-Marie-Tooth disease. Eur J Neurol. 2021 Mar;28(3):974-981.33340200
67. Rossor AM, Kapoor M, Wellington H, et al. A longitudinal and cross-sectional study of plasma neurofilament light chain concentration in Charcot-Marie-Tooth disease. J Peripher Nerv Syst. 2022 Mar;27(1):50-57. Epub 2021 Dec 9.34851050
68. Mariotto S, Farinazzo A, Magliozzi R, Alberti D, Monaco S, Ferrari S. Serum and cerebrospinal neurofilament light chain levels in patients with acquired peripheral neuropathies. J Peripher Nerv Syst. 2018 Sep;23(3):174-177.29974556
69. Bischof A, Manigold T, Barro C, et al. Serum neurofilament light chain: a biomarker of neuronal injury in vasculitic neuropathy. Ann Rheum Dis. 2018 Jul;77(7):1093-1094.28743789
70. Nimer F, Thelin E, Nyström H, et al. Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light. PLoS One. 2015 Jul 2;10(7):e0132177.26136237
71. Shahim P, Zetterberg H, Tegner Y, Blennow K. Serum neurofilament light as a biomarker for mild traumatic brain injury in contact sports. Neurology. 2017 May 9;88(19):1788-1794.28404801
72. Shahim P, Politis A, van der Merwe A, et al. Neurofilament light as a biomarker in traumatic brain injury. Neurology. 2020 Aug 11;95(6):e610-e622.32641538
73. Shahim P, Politis A, van der Merwe A, et al. Time course and diagnostic utility of NfL, tau, GFAP, and UCH-L1 in subacute and chronic TBI. Neurology. 2020 Aug 11;95(6):e623-e636.32641529
74. Karantali E, Kazis D, McKenna J, Chatzikonstantinou S, Petridis F, Mavroudis I. Neurofilament light chain in patients with a concussion or head impacts: a systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2022 Jun;48(3):1555-1567. Epub 2021 May 18.34003313
75. Pekny M, Wilhelmsson U, Stokowska A, Tatlisumak T, Jood K, Pekna M. Neurofilament Light Chain (NfL) in Blood-A Biomarker Predicting Unfavourable Outcome in the Acute Phase and Improvement in the Late Phase after Stroke. Cells. 2021 Jun 18;10(6):1537.34207058
76. Joisten N, Rademacher A, Warnke C, et al. Exercise Diminishes Plasma Neurofilament Light Chain and Reroutes the Kynurenine Pathway in Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm. 2021 Mar 29;8(3):e982.33782190
77. Benedict C, Blennow K, Zetterberg H, Cedernaes J. Effects of acute sleep loss on diurnal plasma dynamics of CNS health biomarkers in young men. Neurology. 2020 Mar 17;94(11):e1181-e1189.31915189
78. Dalla Costa G, Martinelli V, Moiola L, et al. Serum neurofilaments increase at progressive multifocal leukoencephalopathy onset in natalizumab-treated multiple sclerosis patients. Ann Neurol. 2019 Apr;85(4):606-610.30761586

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
140455 Neurofilament Light Chain 140456 Neurofilament Light Chain pg/mL Pending

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