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Neurofilament light chain for classifying the aetiology of alteration of consciousness
Neurofilament light chain has become a promising biomarker for neuroaxonal injury; however, its diagnostic utility is limited to chronic disorders or specific contexts. Alteration of consciousness is a common clinical problem with diverse aetiologies, many of which require timely diagnoses. We evalu...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629465/ https://www.ncbi.nlm.nih.gov/pubmed/37942089 http://dx.doi.org/10.1093/braincomms/fcad278 |
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author | Ongphichetmetha, Tatchaporn Thanapornsangsuth, Poosanu Luechaipanit, Watayuth Loymunkong, Nattawan Rattanawong, Wanakorn Hiransuthikul, Akarin Supharatpariyakorn, Thirawat Sriswasdi, Sira Hemachudha, Thiravat |
author_facet | Ongphichetmetha, Tatchaporn Thanapornsangsuth, Poosanu Luechaipanit, Watayuth Loymunkong, Nattawan Rattanawong, Wanakorn Hiransuthikul, Akarin Supharatpariyakorn, Thirawat Sriswasdi, Sira Hemachudha, Thiravat |
author_sort | Ongphichetmetha, Tatchaporn |
collection | PubMed |
description | Neurofilament light chain has become a promising biomarker for neuroaxonal injury; however, its diagnostic utility is limited to chronic disorders or specific contexts. Alteration of consciousness is a common clinical problem with diverse aetiologies, many of which require timely diagnoses. We evaluated the value of neurofilament light chain alone, as well as creating diagnostic models, in distinguishing causes of alteration of consciousness. Patients presenting with alteration of consciousness were enrolled. Initial clinical data of each participant were evaluated by a neurologist to give a provisional diagnosis. Each participant subsequently received advanced investigations and follow-up to conclude the final diagnosis. All diagnoses were classified into a structural or non-structural cause of alteration of consciousness. Plasma and cerebrospinal fluid levels of neurofilament light chain were measured. Cerebrospinal fluid neurofilament light chain and other clinical parameters were used to develop logistic regression models. The performance of cerebrospinal fluid neurofilament light chain, the neurologist’s provisional diagnosis, and the model to predict the final diagnosis were compared. For the results, among 71 participants enrolled, 67.6% and 32.4% of their final diagnoses were classified as structural and non-structural, respectively. Cerebrospinal fluid neurofilament light chain demonstrated an area under the curve of 0.75 (95% confidence interval 0.63–0.88) which was not significantly different from a neurologist’s provisional diagnosis 0.85 (95% confidence interval 0.75–0.94) (P = 0.14). The multivariable regression model using cerebrospinal fluid neurofilament light chain and other basic clinical data achieved an area under the curve of 0.90 (95% confidence interval 0.83–0.98). In conclusion, neurofilament light chain classified causes of alteration of consciousness with moderate accuracy. Nevertheless, including other basic clinical data to construct a model improved the performance to a level that was comparable to clinical neurologists. |
format | Online Article Text |
id | pubmed-10629465 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106294652023-11-08 Neurofilament light chain for classifying the aetiology of alteration of consciousness Ongphichetmetha, Tatchaporn Thanapornsangsuth, Poosanu Luechaipanit, Watayuth Loymunkong, Nattawan Rattanawong, Wanakorn Hiransuthikul, Akarin Supharatpariyakorn, Thirawat Sriswasdi, Sira Hemachudha, Thiravat Brain Commun Original Article Neurofilament light chain has become a promising biomarker for neuroaxonal injury; however, its diagnostic utility is limited to chronic disorders or specific contexts. Alteration of consciousness is a common clinical problem with diverse aetiologies, many of which require timely diagnoses. We evaluated the value of neurofilament light chain alone, as well as creating diagnostic models, in distinguishing causes of alteration of consciousness. Patients presenting with alteration of consciousness were enrolled. Initial clinical data of each participant were evaluated by a neurologist to give a provisional diagnosis. Each participant subsequently received advanced investigations and follow-up to conclude the final diagnosis. All diagnoses were classified into a structural or non-structural cause of alteration of consciousness. Plasma and cerebrospinal fluid levels of neurofilament light chain were measured. Cerebrospinal fluid neurofilament light chain and other clinical parameters were used to develop logistic regression models. The performance of cerebrospinal fluid neurofilament light chain, the neurologist’s provisional diagnosis, and the model to predict the final diagnosis were compared. For the results, among 71 participants enrolled, 67.6% and 32.4% of their final diagnoses were classified as structural and non-structural, respectively. Cerebrospinal fluid neurofilament light chain demonstrated an area under the curve of 0.75 (95% confidence interval 0.63–0.88) which was not significantly different from a neurologist’s provisional diagnosis 0.85 (95% confidence interval 0.75–0.94) (P = 0.14). The multivariable regression model using cerebrospinal fluid neurofilament light chain and other basic clinical data achieved an area under the curve of 0.90 (95% confidence interval 0.83–0.98). In conclusion, neurofilament light chain classified causes of alteration of consciousness with moderate accuracy. Nevertheless, including other basic clinical data to construct a model improved the performance to a level that was comparable to clinical neurologists. Oxford University Press 2023-10-18 /pmc/articles/PMC10629465/ /pubmed/37942089 http://dx.doi.org/10.1093/braincomms/fcad278 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Ongphichetmetha, Tatchaporn Thanapornsangsuth, Poosanu Luechaipanit, Watayuth Loymunkong, Nattawan Rattanawong, Wanakorn Hiransuthikul, Akarin Supharatpariyakorn, Thirawat Sriswasdi, Sira Hemachudha, Thiravat Neurofilament light chain for classifying the aetiology of alteration of consciousness |
title | Neurofilament light chain for classifying the aetiology of alteration of consciousness |
title_full | Neurofilament light chain for classifying the aetiology of alteration of consciousness |
title_fullStr | Neurofilament light chain for classifying the aetiology of alteration of consciousness |
title_full_unstemmed | Neurofilament light chain for classifying the aetiology of alteration of consciousness |
title_short | Neurofilament light chain for classifying the aetiology of alteration of consciousness |
title_sort | neurofilament light chain for classifying the aetiology of alteration of consciousness |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629465/ https://www.ncbi.nlm.nih.gov/pubmed/37942089 http://dx.doi.org/10.1093/braincomms/fcad278 |
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