A new study led by the University Hospital Bonn (UKB) in cooperation with the Alfried Krupp Hospital Essen shows that the combination of two blood biomarkers – neurofilament light chains (sNfL) and cardiac troponin T (cTnT) – significantly increases diagnostic accuracy in ALS.

While sNfL is already considered an established marker of neuroaxonal damage, it is not specific to ALS. cTnT, on the other hand, a classic heart marker, also shows elevated values in ALS patients due to muscle-specific changes – but without cardiac pathology. In the present study, the diagnostic value of both markers was investigated both individually and in combination.

In total, data from 293 ALS patients were retrospectively comparedwith 85 patientswith other neurodegenerative diseases and 29 healthy controls. In addition, an independent cohort of 501 ALS patients validated the results.

The evaluation using ROC curve analysis showed that the combined biomarker strategy significantly improves the selectivity compared to other diseases – a decisive advance for early diagnosis.

Another finding of the study is the establishment of an ALS-specific threshold value for cTnT at 8.35 ng/L – well below the established cardiological limit (14 ng/L). With this adapted cut-off, the sensitivity of ALS diagnostics could be further increased and additional affected persons could be correctly identified.

The study also shows that ALS patientswith inconspicuous biomarker values (“biomarker-negative”) have significantly slower disease progression than “biomarker-positive” patients. Among the study participants, the median duration of disease in the biomarker-negative group was 73 months compared to 18 months in the biomarker-positive group. The progression of the disease was also significantly slower.

Original Paper:

Combination of Serum Neurofilament Light Chain and Serum Cardiac Troponin T as Biomarkers Improves Diagnostic Accuracy in Amyotrophic Lateral Sclerosis – Lindenborn – Annals of Neurology – Wiley Online Library

Editor: X-Press Journalistenbüro GbR

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