Wang Duo-Zi, Guo Fu-Qiang, Guo Lei, Yang Shu, Yu Neng-Wei, Wang Jian, Wang Jian-Hong
Department of Neurology, The Affiliated Hospital of University of Electronic Science and Technology, Sichuan Provincial People's Hospital, Chengdu, China.
Department of Neurology, Ya'an People's Hospital, Ya'an, China.
Front Psychiatry. 2022 Feb 7;12:764656. doi: 10.3389/fpsyt.2021.764656. eCollection 2021.
Mental health problems after acute ischemic stroke (AIS) have caused wide public concerns, and the study on early identification of these disorders is still an open issue. This study aims to investigate the predictive effect of circulating neurofilament light (NfL) on long-term mental health status of AIS patients.
This study collected demographic information and mental health measurements from 304 AIS patients from May 1, 2016 to Dec 31, 2019. Baseline serum neurofilament light (NfL) was determined within 2 h since patient admission. Six months after AIS onset, the degree of symptoms of depression, anxiety, and insomnia was assessed by the Chinese versions of the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), the 7-item Insomnia Severity Index (ISI), respectively. Subjects were divided into the high NfL group and the low NfL group. Multivariate logistic regression analysis was performed to identify factors associated with these mental health problems.
The high NfL group had significantly higher PHQ-9, GAD-7, and ISI scores than the low NfL group. The prediction of serum NfL for major depression generated a sensitivity of 70.27%, a specificity of 67.79% and an AUC of 0.694. The prediction of serum NfL for anxiety generated a sensitivity of 69.23%, a specificity of 64.02%, and an AUC of 0.683. The prediction of serum NfL for insomnia generated a sensitivity of 75.00%, a specificity of 66.43% and an AUC of 0.723. Higher serum NfL was a risk factor of post-AIS depression [ORs (95% CI): 4.427 (1.918, 10.217)], anxiety [ORs (95% CI): 3.063 (1.939, 6.692)], and insomnia [ORs (95% CI): 4.200 (1.526, 11.562)].
These findings imply that circulating NfL might be a potential biomarker of long-term mental health problems after AIS.
急性缺血性卒中（AIS）后的心理健康问题引起了广泛的公众关注，对这些疾病的早期识别研究仍是一个未解决的问题。本研究旨在探讨循环神经丝轻链（NfL）对AIS患者长期心理健康状况的预测作用。
本研究收集了2016年5月1日至2019年12月31日期间304例AIS患者的人口统计学信息和心理健康测量数据。患者入院后2小时内测定基线血清神经丝轻链（NfL）。AIS发病6个月后，分别采用中文版9项患者健康问卷（PHQ-9）、7项广泛性焦虑障碍量表（GAD-7）、7项失眠严重程度指数（ISI）评估抑郁、焦虑和失眠症状的程度。将受试者分为高NfL组和低NfL组。进行多因素逻辑回归分析以确定与这些心理健康问题相关的因素。
高NfL组的PHQ-9、GAD-7和ISI评分显著高于低NfL组。血清NfL对重度抑郁的预测敏感性为70.27%，特异性为67.79%，曲线下面积（AUC）为0.694。血清NfL对焦虑的预测敏感性为69.23%，特异性为64.02%，AUC为0.683。血清NfL对失眠的预测敏感性为75.00%，特异性为66.43%，AUC为0.723。较高的血清NfL是AIS后抑郁[比值比（95%可信区间）：4.427（1.918，10.217）]、焦虑[比值比（95%可信区间）：3.063（1.939，6.692）]和失眠[比值比（95%可信区间）：4.200（1.526，11.562）]的危险因素。
这些发现表明，循环NfL可能是AIS后长期心理健康问题的潜在生物标志物。
