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Longitudinal prediagnostic serum pNfH levels in patients with ALS. Eleven patients with amyotrophic lateral sclerosis (ALS) had multiple longitudinal prediagnostic samples with a time difference of at least 2 months. A subset of patients (n = 8) with an initial serum phosphorylated neurofilament heavy chain (pNfH) below 300 pg/mL is highlighted with rectangle symbols. The vertical dotted line represents the disease onset, data preceding this line mark the presymptomatic stage.
