Acta neurologica Belgica · 2025
Neurofilament light chain levels as a biomarker in idiopathic intracranial hypertension: correlations with papilledema and radiological findings.
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Hamdy Ahmed, Elgamal Shimaa, Algamal Reem, AboElfarh Hadeer Elsaeed, Elsayed Muhammad Abdelshafi, Moustafa Ahmed Reda Abdelmeguid, Kozaa Yasmeena Abdelall, Egila Hossam, Elshafei Osama
Аннотация
BACKGROUND: Idiopathic intracranial hypertension (IIH) is marked by elevated intracranial pressure with risk of vision loss. Neurofilament light chain (NfL), a marker of axonal injury, may reflect optic nerve damage in IIH.
OBJECTIVE: To assess the relationship between cerebrospinal fluid (CSF) and serum NfL levels, papilledema severity, and radiological findings in patients with IIH.
METHODS: A cross-sectional study was performed on 34 women with IIH and 34 age- and sex-matched healthy controls. Demographics, clinical features, ophthalmological evaluation, lumbar puncture opening pressure measurement, brain MRI/MRV, and ONSD ultrasound were performed. NfL levels were measured in CSF and serum using ELISA. Correlations with papilledema grade (Frisén scale) and radiological findings were analyzed.
RESULTS: IIH patients had higher BMI (34.2 vs. 27.3 kg/m², p < 0.001) and ONSD (6.39 vs. 5.40 mm, p < 0.001). CSF NfL levels were elevated (median 79.8 ng/L) and positively correlated with papilledema grade (r = 0.383, p = 0.031) but negatively with ONSD (r = -0.352, p = 0.041). ONSD correlated strongly with papilledema (r = 0.456, p = 0.009) and lumbar puncture pressure (r = 0.502, p = 0.002). Serum NfL showed no significant difference between patients and controls (p = 0.562) and no correlation with disease severity.
CONCLUSION: CSF NfL correlates with papilledema grade and may serve as an objective biomarker of optic nerve damage in IIH. Its complementary role alongside ONSD suggests potential for a dual biomarker approach, combining acute pressure assessment with cumulative axonal injury monitoring.
OBJECTIVE: To assess the relationship between cerebrospinal fluid (CSF) and serum NfL levels, papilledema severity, and radiological findings in patients with IIH.
METHODS: A cross-sectional study was performed on 34 women with IIH and 34 age- and sex-matched healthy controls. Demographics, clinical features, ophthalmological evaluation, lumbar puncture opening pressure measurement, brain MRI/MRV, and ONSD ultrasound were performed. NfL levels were measured in CSF and serum using ELISA. Correlations with papilledema grade (Frisén scale) and radiological findings were analyzed.
RESULTS: IIH patients had higher BMI (34.2 vs. 27.3 kg/m², p < 0.001) and ONSD (6.39 vs. 5.40 mm, p < 0.001). CSF NfL levels were elevated (median 79.8 ng/L) and positively correlated with papilledema grade (r = 0.383, p = 0.031) but negatively with ONSD (r = -0.352, p = 0.041). ONSD correlated strongly with papilledema (r = 0.456, p = 0.009) and lumbar puncture pressure (r = 0.502, p = 0.002). Serum NfL showed no significant difference between patients and controls (p = 0.562) and no correlation with disease severity.
CONCLUSION: CSF NfL correlates with papilledema grade and may serve as an objective biomarker of optic nerve damage in IIH. Its complementary role alongside ONSD suggests potential for a dual biomarker approach, combining acute pressure assessment with cumulative axonal injury monitoring.