Evidence map›Paper›PMID 42405663›Full record

ArticleEuropean journal of neurology2026

Diagnostic Value of Neurofilament Light Chain and Glial Fibrillary Acidic Protein in Differentiating Primary From Serious Secondary Headache.

Sara-Jessica Camerin, Cihan Atila, Claudine A Blum, Sofia Sandgren, Aleksandra Maleska, Athina Papadopoulou, Jens Kuhle, Mira Katan, Mirjam Christ-Crain

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of neurology, 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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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sara-Jessica CamerinDepartment of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland.
Cihan AtilaDepartment of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-5442-7304
Claudine A BlumDepartment of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland.
Sofia SandgrenMultiple Sclerosis Centre and Research Centre for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
Aleksandra MaleskaMultiple Sclerosis Centre and Research Centre for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
Athina PapadopoulouDepartment of Neurology, University of Basel, University Hospital Basel, Basel, Switzerland.
Jens KuhleMultiple Sclerosis Centre and Research Centre for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-6963-8892
Mira KatanDepartment of Neurology, University of Basel, University Hospital Basel, Basel, Switzerland.
Mirjam Christ-CrainDepartment of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-6336-0965

Funding

Gottfried und Julia Bangerter-Rhyner-StiftungNora van Meeuwen Häfliger StiftungSwiss National Foundation PP0P3_123346Swiss National Foundation PZ00P3_142422the Vizerektorat of the University Basel
6 · The paper itself

Abstract

backgroundHeadache is one of the most frequent reasons for emergency department (ED) visits, and distinguishing primary from secondary headache remains challenging. Blood biomarkers may improve early risk stratification. This study evaluates serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) as potential biomarkers in patients presenting with non-traumatic headache to the ED.

methodsSecondary analysis of a prospective multicenter case-control study at University Hospital Basel and Aarau, Switzerland. Patients presenting with acute non-traumatic headache were included. Final headache diagnoses were adjudicated by two board-certified neurologists. Blood samples obtained at ED presentation were analyzed for sNfL and sGFAP, excluding patients with conditions known to affect biomarker levels. Primary headache samples were matched to serious secondary headache samples. Biomarker levels were expressed as age-, BMI-, and sex-adjusted Z-scores.

resultsA total of 82 patients were analyzed (42 serious secondary, 40 primary headache). Median[IQR] sNfL Z-scores were significantly higher in serious secondary compared with primary headache (0.8 [0.0-1.8] vs. 0.2 [-0.3-0.8]; p < 0.01). sGFAP Z-scores showed an even greater difference (1.2 [-0.1-2.3] vs. -0.2 [-0.7-0.2]; p < 0.001). Both biomarkers demonstrated a specificity of 85%, but sGFAP showed higher sensitivity (57% vs. 43%), NPV (65% vs. 59%), and PPV (80% vs. 75%). In multivariable analysis adjusted for clinical risk factors, sGFAP remained independently associated with serious secondary headache (OR 1.9, 95%-CI 1.2-3.4), whereas sNfL did not. DISCUSSION: sGFAP may represent a promising biomarker to support differentiation between primary and non-traumatic serious secondary headache in the ED, warranting validation in larger cohorts.

Indexed as

Glial Fibrillary Acidic ProteinHeadache Disorders, PrimaryHeadache Disorders, SecondaryNeurofilament ProteinsAdultAgedBiomarkersCase-Control StudiesDiagnosis, DifferentialFemaleHumansMaleMiddle AgedProspective StudiesBiomarkersGFAP protein, humanGlial Fibrillary Acidic Proteinneurofilament protein LNeurofilament ProteinsdiagnosticdifferentiationGFAPheadacheNfLnon‐traumatic brain injuryprimary headacheserious secondary headache

Identifiers

PMID42405663
PMCPMC13334691

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.