Serum neurofilament light chain (sNFL) levels were nearly twice as high in patients with late-onset myasthenia gravis (MG) compared with those with early-onset disease, according to a recent study.
Researchers evaluated sNFL levels in patients with MG to determine whether this marker could assist in disease stratification. The study, published in Frontiers in Medicine, included 60 patients with MG and 29 normal controls. There were no significant differences in age or sex between the groups. Median sNFL levels were higher in patients with MG compared with controls (12.7 pg/mL vs 9.1 pg/mL, p = 0.0176).
Analysis by disease severity showed that patients with quantitative MG scores of 7 to 15 had higher sNFL levels than those with scores of 0 to 6 (median 13.4 pg/mL vs 6.9 pg/mL, p = 0.0207), and both groups differed from controls (p = 0.0023). In stratification by Myasthenia Gravis Foundation of America (MGFA) classification, MGFA-II patients showed significantly higher sNFL levels than controls (p = 0.0437), while MGFA-I patients did not.
When grouped by age of onset, late-onset MG patients (≥50 years) had higher sNFL levels than early-onset patients (<50 years) (median 15.5 pg/mL vs 9.4 pg/mL, p = 0.0368). A mild correlation was observed between age and sNFL levels in patients with MG (p = 0.0477). Receiver operating characteristic analysis indicated that sNFL could distinguish late-onset MG from age-matched controls with an area under the curve of 0.9464 (sensitivity 90 percent, specificity 89.29 percent). For female patients compared with female controls, the area under the curve was 0.8091.
Comparisons between antibody subgroups, including acetylcholine receptor–positive and muscle-specific kinase–positive patients, showed no significant differences, although both groups had higher sNFL levels than controls (p = 0.0490 and p = 0.0164, respectively). Ocular and generalized MG subtypes both showed higher sNFL levels than controls but did not differ significantly from one another.
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