Cerebrospinal fluid levels of chromogranin A and phosphorylated neurofilament heavy chain are elevated in amyotrophic lateral sclerosis.

BACKGROUND: Various cerebrospinal fluid (CSF) biomarkers are being studied to improve the sensitivity and specificity of the diagnostic methods for amyotrophic lateral sclerosis (ALS).

AIMS OF THE STUDY: The aim of our study was to establish the CSF levels of chromogranin A (CgA) and phosphorylated neurofilament heavy chain (pNF-H) in patients with ALS in order to assess these proteins as possible biomarkers of ALS.

METHODS: Cerebrospinal fluid levels of CgA and pNF-H were examined and mutually compared in 15 patients with sporadic ALS and 16 gender- and age-matched controls.

RESULTS: Lumbar CSF CgA levels were increased in the patients with ALS compared to the controls (median 235 vs 138, P=.031). Lumbar CSF pNF-H levels were significantly increased in the patients with ALS compared to the control group (median 3091 vs 213, P<.0001).

CONCLUSIONS: Identifying CSF biomarkers in ALS is important in order to establish the diagnosis in the early stages of the disease. pNF-H seems to be a good biomarker for the diagnosis of ALS. If confirmed on a larger group of patients, CgA may also become useful in the diagnosis of sporadic ALS.