Neurofilament Light Chain

Answers from the Lab

Alicia Algeciras, Ph.D., explains how Mayo Clinic Laboratories’ new blood test, NFLC, can guide treatment decisions for patients with symptoms of cognitive decline, dementia or other neurological disorders. Neurofilament light chain (NfL), is a non-specific biomarker for several neurodegenerative conditions, including Alzheimer’s disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS). The new, plasma-based, assay can determine if cognitive decline may be related to a neurodegenerative condition.

"Neurofilament light chain is specific to neurons and usually isn’t found in blood. But following neuronal injury, neurofilament light chain is released into cerebrospinal fluid and then into blood, where it can be detected,” Dr. Algeciras says.

Existing NfL tests are performed in cerebrospinal fluid. The new assay, developed in conjunction with Mayo Clinic neurologists, reliably detects minute concentrations of NfL in blood.

“If NfL is elevated, the patient’s cognitive decline is likely due to neurodegeneration. If NfL is normal, then the most likely cause of cognitive decline is a non-neurodegenerative process,” Dr. Algeciras says.

That information can help physicians determine treatment pathways and additional testing that would best yield specific diagnoses. “A blood test for NfL is a feasible screening tool that can reduce the number of tests that physicians order up front, which will obviously have an economic benefit,” Dr. Algeciras says.

Mayo's NFLC blood test is also appropriate for monitoring disease progression and treatment response in patients with multiple sclerosis.

The new assay is a laboratory developed test — a designation given to in vitro diagnostic tests designed, manufactured and used within a single laboratory, as opposed to those widely used under Food and Drug Administration approval. Mayo Clinic Laboratories followed strict CLIA requirements to validate the new test, using resources from the Mayo Clinic Study of Aging and the Mayo Clinic Alzheimer’s Disease Research Center.

Dr. Algeciras notes that the sensitivity of the new blood test makes it a potentially useful tool for monitoring the effectiveness of new disease-modifying therapies as they become available, and for measuring the outcomes of clinical trials.

“It’s exciting for Mayo Clinic Laboratories to be providing this assay to support both patient care and clinical trials,” she says.

Listen to learn more about how Mayo Clinic Laboratories’ new NFLC test can guide clinical decision making about the care of patients with cognitive decline.

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Useful information

  • Assessing neuronal damage related to various neurodegenerative diseases.

Specimen requirements

Specimen Type: Plasma EDTA

Patient Preparation: None

Container/Tube: Lavender top (EDTA)

Specimen Volume: 1.50 mL

Collection Instructions: Centrifuge and aliquot plasma into plastic vial. Do not submit in original tube.

Performance information

  • Analytic time: 1 day
  • Day(s) and time(s) performed: Wednesday
  • Specimen Retention Time: 1 to 7 days

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Barbara J. Toman

Barbara J. Toman is a Senior Communications Specialist at Mayo Clinic Laboratories. She is also the science writer for Mayo’s Neurosciences Update newsletter, which helps referring physicians to stay informed about Mayo’s treatment and research. Barbara has worked at Mayo Clinic since 2007. She enjoys international travel and cooking.