- MUNIX
- Neurofilament
- Tau protein
- Blood biomarkers
New Biomarkers of ALS
Motor Unit Number Index (MUNIX)
- Determines number of lower motor neurons supplying a muscle (i.e. motor unit)
- Can be done before clinical weakness becomes apparent by manual muscle testing
- MUNIX is more sensitive to change compared to CMAP and ALSFRS-R
- This makes MUNIX a biomarker candidate for disease progression
Neurofilament
Among the altered biomarkers, CSF Nf-L level remains the best marker of ALS severity, while serum levels correlate strongly with disease progression. The combination of Nf-L and ICAM-1 concentrations in the CSF and IFN-γ concentration in the serum differentiate ALS patients.
Tau Protein
- Tau is a protein that stabilizes the cells’ skeleton via an intermediate phosphorylated Tau (pTau) form
- ALS patients have significantly greater levels of total tau than controls
- Ratio between pTau and total tau is significantly lower in ALS patients, indicating hyperphosphorylation- causes protien clumping
Blood biomarkers
Conclusions
This study suggests that
- Serum Creatinine
- Albumin
- CRP, and
- Glucose
Measured at the time of ALS diagnosis as well as their changes after ALS diagnosis could serve as additional prognostic biomarkers for ALS.
