Clinical significance of serum neurofilament light chain on post-stroke cognitive impairment

ObjectiveTo investigate the correlation between serum neurofilament light chain (NfL) and post-stroke cognitive impairment (PSCI) and its clinical significance.

MethodsSixty health-examination people, 60 patients with acute ischemic stroke (AIS) and 60 patients with PSCI by Montreal congnitive assessment scale(MoCA) were selected.Electrochemiluminescence was used to detect the NfL content in peripheral blood for health control (HC) group, AIS group, and PSCI group.National Institutes of Health stroke scale (NIHSS), MoCA, Barthel index(BI) and biochemical indexes, and modified rankin scale(mRS) were measured in the three groups.

ResultsThere were significant differences in the levels of serum NfL in HC group, AIS group, and PSCI group.The NfL content increased with the increase of nervous system damage and NIHSS score(r=0.724, P < 0.01), increased with with the decrease of self-care ability and BI score(r=-0.670, P < 0.01), and increased with the decrease of cognitive function and MoCA score(r=-0.707, P < 0.01).The NfL content of mild cognitive impairment was lower than that of moderate and severe cognitive impairment.There was also a positive correlation between serum NfL and mRS(r=0.501, P < 0.01), The NfL content increased with the decrease of nerve recovery function.In three groups, there were significant differences in hyperlipidemia, hypertension history, diabetes, and stroke history(P < 0.01), and the difference of biochemical indicator homocysteine was statistically significant(P < 0.01).The area under receiver operating characteristic curve of NfL in PSCI was 0.810(P < 0.01).

ConclusionsNfL content can be used as a biomarker for early diagnosis of PSCI and a novel predictor of the severity of PSCI, which has positive clinical significance for early detection and prevention of PSCI.