Cerebrospinal fluid neurofilament light concentration predicts brain atrophy and cognition in Alzheimer's disease.

ABSTRACT

INTRODUCTION: This study assessed the utility of cerebrospinal fluid (CSF) neurofilament light (NfL) in Alzheimer's disease (AD) diagnosis, its association with amyloid and tau pathology, as well as its potential to predict brain atrophy, cognition, and amyloid accumulation. METHODS: CSF NfL concentration was measured in 221 participants from the Australian Imaging, Biomarkers & Lifestyle Flagship Study of Ageing (AIBL). RESULTS: CSF NfL levels as well as NfL/amyloid ß (Aß42) were significantly elevated in AD compared to healthy controls (HC; P < .001), and in mild cognitive impairment (MCI) compared to HC (P = .008 NfL; P < .001 NfL/Aß42). CSF NfL and NfL/Aß42 differentiated AD from HC with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.84 and 0.90, respectively. CSF NfL and NfL/Aß42 predicted cortical amyloid load, brain atrophy, and cognition. DISCUSSION: CSF NfL is a biomarker of neurodegeneration, correlating with cognitive impairment and brain neuropathology.