Do you typically assess plasma levels of the phosphorylated axonal neurofilament H subunit (pNF-H) in patients with ALS?
Do you typically assess plasma levels of the phosphorylated axonal neurofilament H subunit (pNF-H) in patients with ALS?
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I do not. While I am a fan of using neurofilament levels in trials, I am not yet convinced that these help me care for patients. Several more studies are ongoing which may eventually change my mind.
No, I see no gain testing for any serum level. For the diagnosis, potential biomarkers values in ALS patients have overlap with control subjects and those with other diseases, so none stand alone for the diagnosis. Since they could “support” a diagnosis, I rely on the clinical course, neurologic examination, and electrodiagnostic study for the diagnosis. For treatment, I feel there is no clinical use for tests as results will not change treatment doses or adding a drug.
No, neurofilament levels are typically not collected in clinical practice outside of research protocols, though this might change in the future as new knowledge about the role of neurofilaments emerges.