Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology

Abstract

Background: The diagnostic value of cerebrospinal fluid neurofilament light protein (NfL) in neurology is increasingly recognized as a significant area of research, particularly concerning its role as a biomarker for various neurodegenerative disorders. The literature consistently demonstrates that elevated NfL levels in cerebrospinal fluid (CSF) correlate with disease severity and progression in conditions such as amyotrophic lateral sclerosis (ALS), Alzheimer's disease (AD), and frontotemporal dementia (FTD). Literature Review: The foundational study by (Gagliardi et al., 2019) established NfL as a sensitive marker for axonal degeneration, revealing a direct correlation between elevated NfL levels and diagnostic delays in ALS patients. This was further supported by (M. Forgrave et al., 2019), who highlighted methodological discrepancies in NfL quantification across studies, emphasizing the need for standardized assays to enhance diagnostic reliability. Their systematic review affirmed that while NfL is effective in distinguishing AD from healthy controls, its performance in differentiating AD from mild cognitive impairment (MCI) is less robust. In a broader context, (Delaby et al., 2020) confirmed that increased NfL levels are indicative of clinical severity across multiple neurodegenerative diseases, reinforcing the potential of NfL as a biomarker for early diagnosis and monitoring progression. Conclusion: In conclusion, the body of literature collectively underscores the diagnostic value of cerebrospinal fluid neurofilament light protein (NfL) in neurology, establishing it as a crucial biomarker for neurodegenerative diseases. The evidence highlights NfL's potential for early diagnosis, monitoring disease progression, and improving clinical decision-making. However, standardization of measurement techniques and a comprehensive understanding of NfL's limitations are essential for its effective application in clinical settings.