Observational studyNeurosurgical review2026
Serum neurofilament light chain in hydrocephalus and surgical controls: baseline comparison and 24-hour perioperative dynamics under general anesthesia.
Observational study in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background/Objectives neurofilament light chain (NfL) is a blood-accessible marker of neuroaxonal injury. We assessed the clinical utility of serum NfL in adults with idiopathic normal-pressure hydrocephalus (iNPH). Methods in a single-center prospective cohort (registered at ClinicalTrials.gov; partial overlap with a prior registry detailed in Supplementary Table S1), we enrolled 41 adults aged ≥ 50 years. The hydrocephalus arm included only anticipated ventriculoperitoneal (VP) shunt responders (Group A); non-hydrocephalus surgical patients served as controls (Group B). The primary analysis compared log-transformed serum NfL between groups using Welch’s t-test. A prespecified paired subset was sampled before premedication (baseline) and 24 h after surgery start. As a sensitivity analysis, we fitted age-aware linear models for log(NfL) with group as the exposure and age and sex as covariates. Results serum NfL was right-skewed; analyses used log-transformed values. The primary between-group contrast showed no difference (geometric mean ratio [GMR] 1.03; 95% CI 0.51–2.10; p = 0.93). In age-adjusted models (log[NfL] ~ group + age + sex), the between-group difference remained non-significant with an effect magnitude comparable to the unadjusted GMR. In paired analyses, serum NfL did not change from baseline to 24 h overall (24 h vs. baseline GMR 1.13; 95% CI 0.89–1.45; p = 0.305) and remained non-significant within both Group A (n = 10) and Group B (n = 11). Conclusions in adults ≥ 50 years, serum NfL neither distinguished anticipated VP-shunt responders with iNPH from surgical controls nor exhibited an acute change at 24 h after surgery start under general anesthesia. These findings suggest limited standalone diagnostic/prognostic utility of serum NfL in this setting. Interpretation should be age-aware and integrated with complementary clinical data and biomarkers; future studies should use standardized sampling and multimodal panels to refine risk stratification.
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