Neurofilament light chain predicts risk of recurrence in cerebral amyloid angiopathy-related intracerebral hemorrhage

• DOI: 10.18632/aging.103927
• Publication Date: 2020-11-19T14:00:28Z
• Authors: Xin Cheng; Ya Su; Qiong Wang; Feng Gao; Xiaofei Ye; Yiqing Wang; Yiwei Xia; Jiayu Fu; Yong Shen; Rustam Al-Shahi S...; Qiang Dong
• Keywords: Male; China; Risk Assessment; 03 medical and health sciences; 0302 clinical medicine; Neurofilament Proteins; Predictive Value of Tests; Recurrence; Humans; Prospective Studies; Aged; Cerebral Hemorrhage; Aged, 80 and over; Amyloid beta-Peptides; Middle Aged; Prognosis; Magnetic Resonance Imaging; Peptide Fragments; 3. Good health; Cerebral Amyloid Angiopathy; Case-Control Studies; Female; Biomarkers; Research Paper

Predicting recurrent intracerebral hemorrhage (ICH) related to cerebral amyloid angiopathy (CAA) currently relies on brain images. We aimed to investigate whether blood neurodegenerative biomarkers predict disease severity and ICH recurrence in CAA. We recruited 68 first probable CAA-ICH cases from a Chinese prospective cohort, and 95 controls. We used the single-molecule array to measure acute phase blood amyloid-40, amyloid-42, total tau and neurofilament light chain (NfL). We used multivariable Cox regression models to assess the association between blood biomarkers and CAA-ICH recurrence, and used the concordance (c-) index to assess prediction models. Blood amyloid-42/40, total tau, and NfL levels changed in CAA-ICH cases than controls. During a median follow-up of 2.4 years, NfL was associated with CAA-ICH recurrence (adjusted hazard ratio 2.14, 95% CI 1.57-2.93) independent of MRI burden of small vessel disease (SVD). The performance of a model to predict CAA-ICH recurrence using MRI burden of SVD alone (c-index 0.77) increased with the addition of NfL (c-index 0.88, 95% CI 0.73-1.00, p=0.019). Further, NfL was associated with baseline ICH volume, NIHSS and 6-month mRS score. Blood NfL is associated with severity and prognosis of CAA-ICH and is a promising addition to MRI burden of SVD to predict CAA-ICH recurrence.