Abstract Details

Title An Exploration of Real-world Serum Neurofilament Light Chain Measurement and Rate of ALSFRS-R Decline

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-004

Objective Our aim was to evaluate whether measures used to assess ALS progression in the clinical setting, specifically changes in the Revised ALS Functional Rating Scale (ALSFRS-R) questionnaire, are meaningfully associated with serum neurofilament light chain (NfL) levels measured by a commercial laboratory.

Background Serum NfL, a neuronal cytoplasmic protein, has been proposed as a prognostic marker in ALS. Controlled prospective observational studies have supported single molecule (SIMOA) assay-quantified serum NfL as a predictor of survival and ALSFRS-R rate of change. Given the commercial availability of electrochemiluminescence (ECLIA) serum NfL testing, it may be useful to further explore the utility of NfL alongside existing clinical assessments.

Design/Methods

We conducted an IT-based data extraction to review ECLIA serum NfL tests (Dec 2022-Jan 2025) ordered by Neuromuscular providers for patients in our ALS clinic, and their ALSFRS-R scores at the time of testing (n=25). When available, we also reviewed the ALSFRS-R score from a clinic visit within approximately 180 days (M=120, SD=43) after testing (n=10).

A Spearman rank correlation was calculated for serum NfL levels and patients’ ALSFRS-R scores at the time of NfL testing. This was also performed for serum NfL levels and ALSFRS-R rate of decline, computed in points per month.

Results Although we did not find a correlation between serum NfL levels and one-time ALSFRS-R scores (ρ = -0.1327, p > 0.5), we found a statistically-significant monotonic correlation between serum NfL and a greater rate of decline in ALSFRS-R score (ρ = 0.6810, p < 0.05).

Conclusions Our findings indicate a strong positive correlation. As ALSFRS-R rate of decline increases, the commercially-available serum NfL value also increases. This emphasizes the potential value of tracking serum NfL in the clinical setting alongside ALSFRS-R, providing a possible complementary method of quantifying progression. Future research can examine serum NfL relative to other clinical assessments or medication usage.

Authors/Disclosures
Cate S. Ledoux PRESENTER	Miss Ledoux has nothing to disclose.
Micah Hamilton	Mr. Hamilton has nothing to disclose.
Cassandra Holmes, NP	Ms. Holmes has nothing to disclose.
Nicholas S. Streicher, MD	Dr. Streicher has nothing to disclose.
Shakti Nayar, MD	Dr. Nayar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Nayar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Nayar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ArgenX. Dr. Nayar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi.

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