Evaluation of Serum Neurofilament Light Chain and Nerve Ultrasound in Diabetic Neuropathy

• Published in: Journal of ultrasound in medicine Vol. 43; no. 4; pp. 683 - 696
• Main Authors: Nasr‐Eldin, Yasmin K., Cartwright, Michael S., Hamed, Ahmed, Ali, Lamia Hamdy, Abdel‐Nasser, Ahmed M.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.04.2024
• Subjects: Body Mass Index; Diabetes Mellitus; Diabetic Neuropathies - diagnostic imaging; diabetic polyneuropathy; high‐resolution ultrasonography; Humans; Intermediate Filaments; nerve area; Neural Conduction - physiology; neurofilament light chains; Peripheral Nerves - diagnostic imaging; Ultrasonography - methods; high-resolution ultrasonography; neurofilament light chains; diabetic polyneuropathy; nerve area
• ISSN: 0278-4297; 1550-9613
• DOI: 10.1002/jum.16393

Objective To assess the role of serum neurofilament light chain (NfL) levels in individuals with diabetic polyneuropathy (DPN) compared with controls, as well as to highlight the different sonographic changes in DPN and determine if NfL correlates with sonographic, clinical, and functional parameters. Methods Diabetic individuals with signs or symptoms consistent with peripheral nerve involvement were recruited. They were evaluated by examination, functional neuropathy severity scores, laboratory assessments (including NfL), nerve conduction studies (NCS), and ultrasound. Ultrasound was performed of the bilateral median, ulnar, tibial, fibular, sural, and vagus nerves, and cervical roots 5 and 6. Results were compared with age, sex, and body mass index matched healthy controls. Results A total of 320 nerves from 20 patients and 480 nerves from 30 controls were evaluated. NfL was significantly elevated in those with diabetes with a mean and standard deviation of 6.95 ± 2.95 pg/mL in the diabetic group and 2.83 ± 0.77 pg/mL in controls (P < .001). Nerve cross‐sectional area and serum NfL levels correlated significantly with clinical and functional parameters and with each other (P < .05). Conclusion Individuals with DPN have significantly higher NfL levels than healthy controls, and NfL levels correlate with ultrasonographic parameters. These findings may be useful for the diagnosis, prognosis, and disease monitoring of those with DPN, though further exploration is needed.