Serum neurofilament is associated with motor function, cognitive decline and subclinical cardiac damage in advanced Parkinson's disease (MARK-PD)

Introduction: Serum neurofilament light chain (NfL) levels are associated with disease severity in early Parkinson's disease (PD). We assessed the association of serum NfL with motor and cognitive function and decline in advanced PD patients. Methods: NfL concentrations were analyzed with single molecule array (Simoa) assay in serum of 289 PD patients with advanced disease from the single-center prospective observational biobank study Biomarkers in Parkinson's disease (MARK-PD). Motor and cognitive symptoms were assessed with MDS-UPDRS III, Hoehn&Yahr stages and Montreal Cognitive Assessment (MoCA) at baseline and during 520 [364, 674] days of follow-up. Results: Serum NfL concentrations were associated with Hoehn&Yahr stages. During follow-up, baseline NfL levels were associated with time to cognitive decline in adjusted Cox regression models (hazard ratio: 3.23; 95% CI [1.16, 9.00], P < 0.025). Serum NfL was associated with NT-proBNP in adjusted models linking neuronal and cardiac damage in advanced PD patients. Conclusion: In advanced PD patients, serum NfL concentrations are associated with motor function, cognitive decline and subclinical cardiac damage.