In addition to more specific markers for AD, there is a new blood test called Neurofilament Light Chain, or NFL for short. It’s been offered through Labcorp for about a year, and Quest Diagnostics just started offering it in the last month or so.
This is the summary test description from Quest Diagnotics:
“Neurofilament Light Chain (NfL), Plasma - Neurofilament light (NfL) is an intermediate filament protein found specifically in the neuronal cytoskeleton. It can be released into the extracellular space through axonal degradation, and it has been shown that varying NfL levels are an indicator of neuroaxonal damage, irrespective of the cause, and can therefore be associated with a variety of neurological diseases such as multiple sclerosis, amyotrophic lateral sclerosis, frontotemporal dementia, or Alzheimer’s disease, as well as acute situations such as traumatic brain injury and others. NfL is thus considered a promising biomarker for, disease activity, progression, prognosis, and monitoring effectiveness of therapies. As NfL can be measured in both cerebrospinal fluid (CSF) and blood, it holds great potential for routine clinical use. Light Chain (NfL), Plasma - Neurofilament light (NfL) is an intermediate filament protein found specifically in the neuronal cytoskeleton. It can be released into the extracellular space through axonal degradation, and it has been shown that varying NfL levels are an indicator of neuroaxonal damage, irrespective of the cause, and can therefore be associated with a variety of neurological diseases such as multiple sclerosis, amyotrophic lateral sclerosis, frontotemporal dementia, or Alzheimer’s disease, as well as acute situations such as traumatic brain injury and others. NfL is thus considered a promising biomarker for, disease activity, progression, prognosis, and monitoring effectiveness of therapies. As NfL can be measured in both cerebrospinal fluid (CSF) and blood, it holds great potential for routine clinical use.”
The test lacks specificity, however it can be used as a sensitive biomarker to assess if neuronal loss is within expected parameters for a person’s age group. So if someone is concerned they may have early symptoms that are cognitive or otherwise neurological in nature such as MS or Parkinson’s , this new test, especially when paired with other screening modalities, may help to detect neurological disease at an earlier stage. To give an idea of cost, I found out today that Marek Diagnostics offers it through Labcorp for $406.
There is some conflicting evidence it may be raised somewhat in some persons with major depressive disorder. If so, that suggests that elevations aren’t always linked to conditions that are irreversible.
Per Quest Diagnostics:
“NfL levels can be influenced by many factors, including age, body mass index, kidney disease, and a history of diabetes or cardiovascular conditions. The results of this assay should be considered in conjunction with the findings from medical and family history, neuroimaging, and physical, neurological, and neuropsychological examination.“