Squitti Rosanna, Fiorenza Antonio, Martinelli Alessandra, Brembati Viviana, Crescenti Daniela, Rongioletti Mauro, Ghidoni Roberta
Department of Laboratory Science, Research and Development Division, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, Italy.
Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy.
Int J Mol Sci. 2024 Dec 25;26(1):61. doi: 10.3390/ijms26010061.
Severe mental disorders (SMDs), such as schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD), are heterogeneous psychiatric diseases that impose a significant societal burden due to their chronic disabling nature. There are no objective and reliable diagnostic tests for SMDs; thus, there is an urgent need for specific biomarkers to improve diagnosis, treatment, and resource allocation. Neurofilaments, found in cerebrospinal fluid and blood, offer reliable diagnostic and prognostic potential. This review discusses the link between neurofilament light chain (NfL) involvement in psychiatric and neurodegenerative diseases and gives insights into the diagnostic and prognostic value of NfL in SMDs. This systematic review searched PubMed, Scopus, and Web of Science databases to answer the research question "Are NfL levels higher in individuals with SMDs compared to healthy controls?" using terms related to neurofilament, SMDs, SZ, BD, and depression. Of 8577 initial papers, 115 were relevant. After exclusions and manual additions, 17 articles were included. Studies indicate elevated NfL levels in SMDs compared to healthy controls, suggesting its potential as a biomarker for SMDs and for distinguishing neurodegenerative diseases from psychiatric disorders. However, further longitudinal research is needed to confirm its reliability for differential diagnosis, disease prediction, and treatment assessment in psychiatry.
重度精神障碍（SMD），如精神分裂症（SZ）、双相情感障碍（BD）和重度抑郁症（MDD），是异质性精神疾病，因其慢性致残性而给社会带来了沉重负担。目前尚无针对SMD的客观可靠的诊断测试；因此，迫切需要特异性生物标志物来改善诊断、治疗和资源分配。在脑脊液和血液中发现的神经丝具有可靠的诊断和预后潜力。本综述讨论了神经丝轻链（NfL）与精神疾病和神经退行性疾病之间的联系，并深入探讨了NfL在SMD中的诊断和预后价值。本系统综述检索了PubMed、Scopus和Web of Science数据库，使用与神经丝、SMD、SZ、BD和抑郁症相关的术语，以回答研究问题“与健康对照相比，SMD患者的NfL水平是否更高？”。在8577篇初始论文中，115篇相关。经过排除和手动补充，纳入了17篇文章。研究表明，与健康对照相比，SMD患者的NfL水平升高，这表明其有潜力作为SMD的生物标志物，以及用于区分神经退行性疾病和精神疾病。然而，需要进一步的纵向研究来证实其在精神病学鉴别诊断、疾病预测和治疗评估中的可靠性。
