NfL tests improve ALS diagnosis and prognosis accuracy

New research indicates that four blood tests, which measure neurofilament light chains (NfL), can accurately diagnose amyotrophic lateral sclerosis (ALS) and predict its progression. The findings could help improve clinical practices for this rare disease. The study involved 139 ALS patients and 70 healthy individuals. The average age of the ALS patients was 67.3 years, and about half were women. Researchers compared the performance of four testing technologies: Ultrasensitive Simoa, microfluidic Ella, and two clinical-grade platforms called Lumipulse and Elecsys. Results showed a strong correlation among the four testing methods. All demonstrated good diagnostic capabilities. However, the Simoa test had a lower accuracy score compared to the other three methods. Alongside NfL measurements, the study also assessed two other substances called GFAP and pTau181, but found them to be poor for diagnosing ALS. Significantly, the NfL levels provided important prognostic information. Patients with elevated NfL levels faced very low survival rates, while those with lower levels had a considerably better chance of survival over the same period. The researchers noted that these tests could be crucial for confirming ALS diagnoses, especially in complex cases. They proposed specific cutoff values for NfL levels that could guide future laboratory tests. It’s important to note that the study participants were from southern France, which may limit how widely the results can be applied to other populations. The research was funded by medical foundations and reported no conflicts of interest from the investigators.