Ann Neurol: The association between plasma nerve wire light chain protein and postoperative delirium.

A recent study published in Annals of Neurology, an authoritative journal in the field of neurology, aims to assess the relationship between the plasma neuroaxial damage marker neurofilament light chain protein (NfL), total tau protein, glial fibroids, and ubiquitin-based end esterase l1 and delirium, delirium severity, and cognitive abilities.
the study's delirium cases were paired with those without delirium controls (n-108) by age, sex, type of surgery, cognition, and angiocomplis.
researchers used Quanterix to measure biomarkers in the subjects' plasma 2 days after surgery (PREOP), 2 days after surgery (POD2) and 30 days after surgery (PO1MO).
researchers used confusion assessment methods (CAM) and CAM-S (severity) to measure the severity of delirium and delirium, respectively.
researchers used General Cognitive Performance (GCP) scores to measure cognitive function.
high NfL levels for POD2 and PO1MO in cases of delirium (the median difference between the paired pairs was 16.2pg/ml and 13.6pg/ml, respectively).
increased risk of delirium in patients with PREOP and POD2 NfL in the highest quarterile (Q4) range (adjusted OR=3.7 (95% CI 1.1-12.6) and 4.6 (1.2-18.2) respectively) and experienced more severe delirium, Cam-S scores 7.8 (95% CI 1.6-14.0) and 9.3 (95% CI 3.2-15.5).
at PO1MO, the NFL level of delirium cases continued to rise (adjusted OR 9.7; 95% CI was 2.3-41.4), and in patients with NfL level Q4, GCP scores dropped by 2.3 points (-2.3 points, 95% CI -4.7 to -0.9).
result, patients with the highest levels of PREOP or POD2 NfL are more likely to develop delirium.
NfL increase in PO1MO is associated with delirium and greater cognitive decline.
these findings suggest that NfL can be used as a predictive biomarker of delirium risk and long-term cognitive decline and, if confirmed, will provide pathophysiological evidence for post-delirium axon damage.
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