Geran Rohat, Steiner Oliver L, Krasivskaya Elena, Hannemann Ulrike, Klostermann Fabian
Department of Neurology, Motor and Cognition Group, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany.
Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
J Neurol. 2025 Jun 3;272(6):439. doi: 10.1007/s00415-025-13179-w.
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a dysimmune disease primarily targeting the Schwann cell myelin sheath in the peripheral nervous system (PNS), resulting in sensorimotor deficits. Surprisingly, subtle cognitive impairments as well as axonal damage, indicated by elevated serum neurofilament light chain (sNfL), prevail in CIDP. This study investigated whether elevated sNfL is associated with lower cognitive performance in CIDP.
Thirty-five CIDP patients underwent digital cognitive testing across multiple domains, alongside assessments of sociodemographic, clinical, and sNfL measures. Patients were stratified into low- and high-sNfL groups based on the median value, and clinical variables were compared. Further, general linear models, controlled for clinical and sociodemographic factors, were employed to evaluate the predictive value of sNfL for global and domain-specific cognitive functioning.
Higher sNfL values were associated with worse general cognitive performance (β = -0.31, p = 0.016) and reduced processing speed (β = -0.40, p = 0.008). Patients with increased sNfL levels had a longer disease duration (p = 0.016), also linked to poorer cognitive outcome (β = -0.26, p = 0.045).
In this CIDP cohort, high sNfL levels were associated with reduced cognitive performance and longer disease duration. The findings suggest that sNfL is a clinical meaningful biomarker for the detection and monitoring of central involvement in the course of CIDP, a condition traditionally viewed as purely peripheral.
慢性炎性脱髓鞘性多发性神经病（CIDP）是一种主要针对外周神经系统（PNS）中施万细胞髓鞘的免疫性疾病，可导致感觉运动功能障碍。令人惊讶的是，CIDP患者普遍存在细微的认知障碍以及血清神经丝轻链（sNfL）升高所表明的轴突损伤。本研究调查了sNfL升高是否与CIDP患者较低的认知表现相关。
35例CIDP患者接受了多个领域的数字认知测试，同时进行了社会人口统计学、临床和sNfL测量评估。根据中位数将患者分为低sNfL组和高sNfL组，并比较临床变量。此外，采用控制了临床和社会人口统计学因素的一般线性模型来评估sNfL对整体和特定领域认知功能的预测价值。
较高的sNfL值与较差的总体认知表现（β = -0.31，p = 0.016）和处理速度降低（β = -0.40，p = 0.008）相关。sNfL水平升高的患者病程较长（p = 0.016），这也与较差的认知结果相关（β = -0.26，p = 0.045）。
在这个CIDP队列中，高sNfL水平与认知表现降低和病程较长相关。研究结果表明，sNfL是检测和监测CIDP病程中中枢受累情况的一种具有临床意义的生物标志物，CIDP传统上被视为纯粹的外周疾病。
