Elevated plasma neurofilament light chain protein in alcohol use, anorexia nervosa, mania, psychosis and other acute psychiatric disorder presentations
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Objective
To investigate plasma neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) levels across a range of acute psychiatric disorder presentations, and to determine whether elevations are specific to certain diagnoses.
Methods
We analysed biobanked lithium heparin plasma samples from 121 patients with acute psychiatric presentations (including mania, psychosis, alcohol use disorder, anorexia nervosa, depression, and adjustment disorder), and 59 healthy controls. NfL and GFAP were measured using Simoa assays. Group differences were compared via bootstrapped general linear models adjusted for age, sex, and weight.
Results
NfL was significantly elevated in alcohol use disorder, anorexia nervosa, mania, and psychosis compared to controls, but not in depression or adjustment disorder. GFAP was elevated only in alcohol use disorder.
Conclusions
Plasma NfL and GFAP are not uniformly elevated across psychiatric disorders. Elevations in specific acute disorders likely reflect underlying neuronal and astroglial injury. These results support nuanced, biologically grounded, diagnosis and stage-specific roles for these biomarkers in psychiatry.
Statistical analysis conducted by:
Dr Dhamidhu Eratne
