Aktuelle Neurologie 2005; 32 - P612
DOI: 10.1055/s-2005-919643

Biomarkers for axonal damage in amyotrophic lateral sclerosis indicate upper motor neuron involvement and correlate with disease progression

J Brettschneider 1, A Petzold 1, S.D Süssmuth 1, A.C Ludolph 1, H Tumani 1
  • 1Ulm; London, UK

Amyotrophic lateral sclerosis is a neurodegenerative disease characterized by the loss of motor neurons located in the spinal cord, brainstem and motor cortex. This study tested whether biomarkers for axonal degeneration correlate with clinical subtypes and are of prognostic value regarding progression of disease.

Patients with ALS (N=69) and age-matched controls (N=33) were included into this prospective study. Cerebrospinal fluid (CSF) levels of tau protein and neurofilaments (NfHSMI35) were measured using ELISA. In 31 patients with ALS, follow-up data was available (Median follow-up 7 months).

Levels of CSF NfHSMI35 were 5-fold (1.7 ng/mL) and of tau 2-fold (232 pg/mL) elevated in patients with ALS compared to controls (0.3 ng/mL, p<0.001 and 153 pg/mL, p=0.02, respectively). Additionally CSF NfHSMI35 concentrations were higher in patients with clinical and electrophysiological evidence for upper (2.3 ng/mL) compared those with lower motor neuron involvement (1.2 ng/mL, p=0.02). Finally patients with rapid disease progression had CSF higher NfHSMI35 levels (2.4 ng/mL) compared to those who progressed slower (1.2 ng/mL, p=0.02).

Biomarkers for axonal damage distinguish subgroups of patients with ALS, correlate with disease progression and might be a valuable secondary outcome measure for future neuroprotective treatment strategies.