. Association of Plasma Neurofilament Light With Neurodegeneration in Patients With Alzheimer Disease. JAMA Neurol. 2017 May 1;74(5):557-566. PubMed.

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  1. I think it is unlikely that plasma NfL will be useful as a longitudinal indicator of treatment response in AD studies any time soon. While it is intriguing that this blood marker does reflect, to some extent, neurodegeneration, it is not a particularly robust measure and it would be difficult to put much weight on treatment effects. On the other hand, plasma NfL could be useful in the effort to prescreen individuals for more expensive tools, such as amyloid and tau PET scans, used to select individuals for early intervention trials.

    View all comments by Paul Aisen
  2. We agree with Dr. Aisen that plasma NfL may potentially be useful as a biomarker for prescreening individuals who are selected for further testing before inclusion in early intervention trials. We think this is one of the most interesting possible future applications of plasma NfL, although more work is needed to clarify exactly how to operationalize this new biomarker, and how the findings from the ADNI study translate to a more general population. We also agree that the present study, which only includes cross-sectional measurements of plasma NfL, does not in itself support longitudinal plasma NfL measurements to track treatment response. We therefore suggest to continue with true longitudinal studies of plasma NfL, to quantify its variability over time, and correlate it with longitudinal changes in other markers of degeneration and disease progression.

    View all comments by Ulf Andréasson

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