Blood neurofilament light chain as a biomarker for cognitive impairment in adults with epilepsy: Integrated evidence from clinical cohorts in Northeast China and European <scp>GWAS</scp> data
Bibliographic record
Abstract
OBJECTIVE: Epilepsy treatment aims not only to control seizures but also to enhance quality of life. However, reliable blood-based biomarkers for epilepsy-related cognitive impairment are lacking. This study investigated the association between plasma neurofilament light chain (NfL) levels and cognitive function in epilepsy by integrating evidence from observational and Mendelian randomization (MR) analyses across different populations. METHODS: We conducted a cross-sectional observational study at the First Hospital of Jilin University, enrolling 152 adults with epilepsy. Demographic and clinical information was collected, and cognitive status and psychological status were assessed using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Memory and Executive Screening (MES) scale, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD). Plasma NfL levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses included logistic regression, linear regression, and receiver-operating characteristic (ROC) curve analysis. In parallel, two-sample MR was performed using genome-wide association study (GWAS) summary statistics from European cohorts. Shared genetic variants between epilepsy and cognitive impairment were identified using multi-trait analysis of GWAS (MTAG) and cross-phenotype association (CPASSOC), and served as instrumental variables to estimate the causal effect on plasma NfL levels. RESULTS: Plasma NfL levels were significantly higher in the cognitively impaired group. After adjusting for confounders, elevated NfL levels remained independently associated with increased risk of cognitive impairment and inversely correlated with cognitive scores. ROC curve analysis showed high diagnostic accuracy of plasma NfL. MR analysis confirmed a positive causal relationship between epilepsy-related cognitive impairment and plasma NfL levels. SIGNIFICANCE: Plasma NfL is associated with cognitive impairment in epilepsy and may serve as an early blood-based biomarker for identifying cognitive dysfunction in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".