sTREM2 cerebrospinal fluid levels are a potential biomarker in amyotrophic lateral sclerosis and associate with UMN burden.

Objectives: The aims of this study were to investigate whether CSF sTREM2 may be a potential marker of disease monitoring for amyotrophic lateral sclerosis (ALS).

Methods: We investigated whether CSF sTREM2 levels are altered in ALS patients and are correlated with upper motor neuron (UMN) burden and disease progression.

Results: CSF sTREM2 was greater in the ALS patients than in the controls ( = 0.002). Elevated CSF sTREM2 was associated with the UMN score ( = 0.38,  = 0.009), ΔFS ( = 0.30,  = 0.04) and serum NFL (lg) ( = 0.35,  = 0.015). As the motor band sign (MBS) score increased, the CSF sTREM2 level increased (-trend = 0.014). Furthermore, the correlations became stronger (UMN score ( = 0.50,  = 0.01) ΔFRS ( = 0.52,  = 0.008) and serum NFL (lg) ( = 0.55,  = 0.004) when estimated only among patients with a disease duration >12 months.

Conclusion: We found that CSF sTREM2 is elevated in ALS patients and may be a novel marker, probably reflecting upper motor unit severity and prognosis.