Serum Levels of Neurofilament Light Chains in detection of Minimal Hepatic Encephalopathy in patients with liver cirrhosis

Objectives : To evaluate The function of light chains in neurofilament (NFLC) in detection and early diagnosis of minimal hepatic encephalopathy (MHE) in liver cirrhosis (LC) patients. Background : MHE is a cognitive and neuropsychiatric syndrome due to hepatic diseases and associated central nervous system (CNS) damage. MHE has been detected using several diagnostic tools, including psychometric tests, electroencephalograms and evoked potentials (EP). Recently, the diagnostic utility of non-invasive biomarkers for MHE has gained popularity but still not sufficiently proven. Patients and methods: 150 people participated in this case control research. participants divided into three equal groups: group 1 (50 cirrhotic patients with MHE), group 2 (50 cirrhotic patients without MHE), and group 3 (a control group of 50 healthy volunteers). All patients underwent full history-taking, a detailed clinical examination; MHE was diagnosed using the Psychometric Hepatic Encephalopathy Score (PHES) and laboratory investigations were done with measurement of NFLC serum levels by ELISA. Results : Serum levels of NFLC showed a high significant variation between the three groups under study that had the highest elevation reported in MHE group (644.0 ± 153.1) and the lowest in control group (61.10 ± 16.53). Serum NFLC at cutoff point (>420 pg /ml) had a sensitivity in prediction of MHE of 98.0%, a specificity of 96.0%, PPV of 96.1%, NPV of 98.0%. The AUC was 0.996 with a high significant variation (p<0.001). Conclusion : Higher NFLC levels were associated with MHE with a significant reverse correlation between NFLC and PHES which gave an initial conclusion about NFLC role in early detection f MHE.