Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Clinical laboratory, Nagoya University Hospital, Nagoya, Japan.
Epileptic Disord. 2023 Apr;25(2):229-236. doi: 10.1002/epd2.20024. Epub 2023 May 3.
The neurofilament light chain (NfL) is receiving increased attention as a biomarker of neurological diseases, as NfL concentration elevated in the blood and cerebrospinal fluid after neuronal damage. However, few studies have addressed NfL in epilepsy. We aimed to investigate the alteration of serum NfL in adult patients with epilepsy, and the association between this biomarker and cognitive impairment.
A total of 38 consecutive patients with epilepsy and 24 controls underwent cross-sectional measurement of serum NfL levels and cognitive testing using the Mini-Mental State Examination (MMSE), the Japanese version of the Montreal Cognitive Assessment (MoCA-J), the Frontal Assessment Battery (FAB), the Trail-Making Test, and the Stroop Color-Word Test. Statistical analysis was performed with Student's t-test to compare serum NfL levels between the epilepsy group and the control group, and with Spearman's correlation and age-corrected partial correlation analyses to evaluate the association between serum NfL level and cognitive impairment in epilepst patients.
There was no difference in serum NfL levels between the epilepsy and control groups (epilepsy [mean ± SD]: 17.3 ± 13.9 pg/mL; control: 17.7 ± 11.5 pg/mL; p = .92); however, the MoCA-J scores were lower in the epilepsy group (26.6 ± 3.1 vs. 28.1 ± 1.6; p = .03). The age-corrected partial correlation analysis showed a correlation between serum NfL level and cognitive test scores in the epilepsy group (MMSE: r = -.63, p < .01; MoCA-J: r = -.54, p < .01; FAB: r = -.68, p < .01), whereas serum NfL levels were correlated exclusively with MMSE scores in the control group (r = .44, p = .04).
In adult epilepsy patients, the serum NfL level was not significantly elevated, but was correlated with cognitive test scores. Our findings suggest that serum NfL concentration could be an indicator of cognitive function in epilepsy patients.
神经丝轻链（NfL）作为神经疾病的生物标志物受到越来越多的关注，因为神经元损伤后血液和脑脊液中的 NfL 浓度升高。然而，很少有研究涉及癫痫中的 NfL。我们旨在研究成年癫痫患者血清 NfL 的变化，以及该生物标志物与认知障碍之间的关系。
共 38 例癫痫患者和 24 例对照者进行了血清 NfL 水平的横断面测量，并使用简易精神状态检查（MMSE）、蒙特利尔认知评估日本版（MoCA-J）、额叶评估量表（FAB）、连线测试和斯特鲁普色词测验进行认知测试。采用学生 t 检验比较癫痫组和对照组的血清 NfL 水平，采用 Spearman 相关分析和年龄校正的偏相关分析评估癫痫患者血清 NfL 水平与认知障碍的关系。
癫痫组和对照组之间血清 NfL 水平无差异（癫痫组[均值±标准差]：17.3±13.9 pg/mL；对照组：17.7±11.5 pg/mL；p=0.92）；然而，癫痫组的 MoCA-J 评分较低（26.6±3.1 与 28.1±1.6；p=0.03）。年龄校正的偏相关分析显示，癫痫组血清 NfL 水平与认知测试评分之间存在相关性（MMSE：r=-0.63，p<0.01；MoCA-J：r=-0.54，p<0.01；FAB：r=-0.68，p<0.01），而对照组中血清 NfL 水平仅与 MMSE 评分相关（r=0.44，p=0.04）。
在成年癫痫患者中，血清 NfL 水平没有显著升高，但与认知测试评分相关。我们的发现表明，血清 NfL 浓度可能是癫痫患者认知功能的指标。
