Why the study?
Although neurofilament light chain is used as a biomarker for neurodegenerative decline, its use in surgery- and anaesthesia-induced acute cognitive dysfunction remains controversial.
Do neurofilament light chain (NfL) levels correlate with the development of perioperative neurocognitive disorders such as postoperative delirium?
Do neurofilament light chain (NfL) levels correlate with the development of perioperative neurocognitive disorders such as postoperative delirium?
Elevated preoperative and postoperative blood and CSF NfL levels are associated with a higher risk of postoperative delirium, suggesting its potential as a biomarker for perioperative neurocognitive disorders.
Supports NfL as a candidate POD biomarker but should not change practice; leaves open its role in other PND pending prospective validation.
Although the neurofilament light chain (NfL) is used as a biomarker for neurodegenerative decline, its use in surgery- and anaesthesia-induced acute cognitive dysfunction remains controversial. We aimed to synthesise the evidence to explore the potential of NfL as an established biomarker for perioperative neurocognitive disorders (PND). We systematically searched the PubMed, EMBASE, MEDLINE, Cochrane Library electronic databases, and Cochrane Central Registry of Clinical Trials. Our results show that CSF NfL levels positively correlated with blood NfL levels (r = 0.63; 95% confidence interval [CI], 0.42-0.77). The pooled standardised mean difference (SMD) showed a significantly higher preoperative CSF NfL levels (SMD = 0.27; 95% CI, 0.07-0.47) and both pre- and postoperative blood NfL levels (SMD = 0.53, 95% CI, 0.40-0.66 and SMD = 0.58, 95% CI, 0.43-0.73) in the postoperative delirium (POD) group. Postoperative blood NfL levels were significantly elevated in both POD group (SMD = 0.49; 95% CI, 0.34-0.64) and no-POD group (SMD = 0.67; 95% CI, 0.53-0.81). Our meta-analysis indicates that NfL may serve as a potential biomarker for POD, and elevated preoperative blood NfL levels could be a risk factor for POD. Further studies are needed to confirm the association of CSF/blood NfL levels with other PND types.
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Chen et al. (2024) studied this question.
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