Elevated plasma neurofilament light chain protein in alcohol use, anorexia nervosa, mania, psychosis and other acute psychiatric disorder presentations
Bibliographic record
Abstract
Abstract 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 Among 180 participants, adjusted NfL was significantly elevated compared with controls in alcohol use disorder (β=1.32, p=0.002), anorexia nervosa (β=0.86, p<0.001), mania (β=0.44, p=0.015), and psychosis (β=0.34, p=0.034), but not in depression or adjustment disorder. Unadjusted NfL was highest in alcohol use disorder (mean 43 pg/mL) and anorexia nervosa (20 pg/mL) versus controls (9 pg/mL). Adjusted GFAP was elevated only in alcohol use disorder (β=1.01, p=0.024). Conclusions Plasma NfL and GFAP are not uniformly elevated across psychiatric disorders, but show a disorder-specific pattern, with the largest elevations in alcohol use disorder and anorexia nervosa and more modest elevations in mania and psychosis. These findings support nuanced, biologically grounded, diagnosis- and stage-specific interpretation of these biomarkers in psychiatry, and caution against interpreting a single elevated value as evidence of neurodegeneration. Because some acute psychiatric presentations show elevations approaching the neurodegenerative range, control-derived reference ranges may be insufficient when distinguishing neurodegeneration from primary psychiatric disorders, supporting the need for diagnosis- and state-specific reference data.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".