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Neurofilament Light Chain, CSF (CLEIA)

Order Code
2925038
CPT
84394
Test Details
Synonyms

NfL

TAT

7 Days

Methodology

Chemiluminescent Enzyme Immunoassay (CLEIA)

Reference Interval

Age group 30 years – 79 years: ≤ 620 ng/L ≥ 80 Years: ≤ 2104 ng/L

Remarks

NfL is a marker of axonal injury and neurodegeneration, and concentrations rise with age. Results must therefore be interpreted using age-adjusted reference ranges, which were developed by the University of Gothenburg Clinical Laboratory (Sweden) and Neurocode (USA), and are used with permission.

• Values below the age-specific reference interval indicate no biochemical evidence of significant ongoing neuroaxonal injury.
• Values above the age-specific cutoff suggest increased neuroaxonal damage, which may occur in a wide range of neurological disorders, including frontotemporal dementia (FTD), cerebrovascular disease, traumatic brain injury, inflammatory or demyelinating conditions, and systemic diseases affecting the nervous system.

NfL is not disease-specific, and elevated levels must be interpreted alongside clinical findings, neuroimaging, and complementary biomarkers (e.g., Amyloid β-42/40 ratio, p-tau181, p-tau217). In patients under 65 years, an elevated NfL with normal p-tau or a normal Amyloid β-42/40 ratio increases the likelihood of a rapidly progressive neurodegenerative disorder, such as FTD, rather than Alzheimer’s disease.

Performing Location

Accredited NRL Laboratory

Testing Frequency

Weekly

Test Overview

Neurofilament light chain (NfL) is a structural protein of the neuronal cytoskeleton that is released into cerebrospinal fluid and blood following axonal injury. Elevated NfL levels reflect neuroaxonal damage regardless of cause and may be observed in a wide range of neurological conditions, including multiple sclerosis, amyotrophic lateral sclerosis, frontotemporal dementia, Alzheimer’s disease, and acute neurological injury such as traumatic brain injury.

Specimen Type

CSF

Volume

Minimum 0.5 mL

Specimen Container

Sarstedt sterile polypropylene tubes

Patient Preparation

Preferably, the lumbar puncture should be performed in the morning.

Collection

Perform the lumbar puncture at the L3/L4 or L4/L5 intervertebral space. Collect the cerebrospinal fluid in an appropriate polypropylene tube and transport it frozen at –20°C.

Specimen Stability
Temperature Period
Frozen 2 months
Order Code
2925038
CPT
84394
Test Details
Synonyms

NfL

TAT

7 Days

Methodology

Chemiluminescent Enzyme Immunoassay (CLEIA)

Reference Interval

Age group 30 years – 79 years: ≤ 620 ng/L ≥ 80 Years: ≤ 2104 ng/L

Remarks

NfL is a marker of axonal injury and neurodegeneration, and concentrations rise with age. Results must therefore be interpreted using age-adjusted reference ranges, which were developed by the University of Gothenburg Clinical Laboratory (Sweden) and Neurocode (USA), and are used with permission.

• Values below the age-specific reference interval indicate no biochemical evidence of significant ongoing neuroaxonal injury.
• Values above the age-specific cutoff suggest increased neuroaxonal damage, which may occur in a wide range of neurological disorders, including frontotemporal dementia (FTD), cerebrovascular disease, traumatic brain injury, inflammatory or demyelinating conditions, and systemic diseases affecting the nervous system.

NfL is not disease-specific, and elevated levels must be interpreted alongside clinical findings, neuroimaging, and complementary biomarkers (e.g., Amyloid β-42/40 ratio, p-tau181, p-tau217). In patients under 65 years, an elevated NfL with normal p-tau or a normal Amyloid β-42/40 ratio increases the likelihood of a rapidly progressive neurodegenerative disorder, such as FTD, rather than Alzheimer’s disease.

Performing Location

Accredited NRL Laboratory

Testing Frequency

Weekly

Test Overview

Neurofilament light chain (NfL) is a structural protein of the neuronal cytoskeleton that is released into cerebrospinal fluid and blood following axonal injury. Elevated NfL levels reflect neuroaxonal damage regardless of cause and may be observed in a wide range of neurological conditions, including multiple sclerosis, amyotrophic lateral sclerosis, frontotemporal dementia, Alzheimer’s disease, and acute neurological injury such as traumatic brain injury.

Specimen Type

CSF

Volume

Minimum 0.5 mL

Specimen Container

Sarstedt sterile polypropylene tubes

Patient Preparation

Preferably, the lumbar puncture should be performed in the morning.

Collection

Perform the lumbar puncture at the L3/L4 or L4/L5 intervertebral space. Collect the cerebrospinal fluid in an appropriate polypropylene tube and transport it frozen at –20°C.

Specimen Stability
Temperature Period
Frozen 2 months