Neurofilament light may be used as blood-based measure for peripheral neuropathy

The blood-based measure of neurofilament light chain was associated with the presence of neuronal injury in those with peripheral neuropathy, according to a systematic review and meta-analysis in JAMA Network Open.

“Peripheral neuropathies are common conditions and can result in numbness, paresthesia, motor deficits and pain. There is increasing evidence for the use of biomarkers as clinical indicators of the presence, severity and prognosis of nerve lesions,” Joel Fundaun, DPT, a PhD candidate at the University of Oxford, and colleagues wrote.

Fundaun and colleagues sought to assess blood-based biomarker concentrations linked to nerve involvement in patients with peripheral neuropathy. The authors included observational studies that reported on blood biomarkers in those diagnosed with peripheral neuropathy.

The researchers meta-analyzed data when at least two studies reported on the same biomarker with comparable methodology. Fixed-effect models were used when only two studies were included for the same biomarker; random-effect models were used when more than two studies were included.

Thirty-six studies reporting on 4,414 participants, including 2,113 controls and 2,301 patients with peripheral neuropathy with 13 distinct peripheral neuropathy diagnoses, were evaluated. Diabetic neuropathy was the most common neuropathy diagnosis (13 studies), followed by Charcot-Marie-Tooth disease (six studies) and Guillain-Barre syndrome (six studies).

Overall, 16 blood-based biomarkers that were associated with nerve involvement were evaluated. The most used were neurofilament light chain, S100B, brain-derived neurotrophic factor and neuron-specific enolase.

Those with peripheral neuropathy demonstrated higher levels of neurofilament light chain compared with controls (standard mean difference = 0.93; 95% CI, 0.82-1.05). There were no significant differences in levels of S100B (SMD = 1.1; 95% CI, –3.08 to 5.28), brain-derived neurotrophic factor (SMD = –0.52; 95% CI, –2.23 to 1.19) or neuron-specific enolase (SMD = 0; 95% CI, –1.99 to 1.98) in patients with peripheral neuropathy, compared with controls.

“When compared with other nerve-related biomarkers, [neurofilament light] was consistently increased in patients with varying types of peripheral neuropathies compared with control participants,” the authors wrote.