Evidence map›Paper›PMID 42443712›Full record

ArticleNeurocritical care2026

Neurofilament Light Protein: A Marker for Injury Severity, Clinical Course, and Outcome Following Moderate to Severe Traumatic Brain Injury.

Spyridoula Tsetsou, Leah E McQuillan, Vishruth P Reddy, David J Barton, Damon G Lamb, Firas Kobeissy, Guangzheng Cai, Richard Rubenstein, Kevin K W Wang, John B Williamson and 2 more

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Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

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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

12 authors.

Spyridoula TsetsouDepartment of Neurology, Baylor College of Medicine, Houston, TX, USA.
Leah E McQuillanDepartment of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.
Vishruth P ReddyDepartment of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.
David J BartonDepartment of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Damon G LambDepartment of Psychiatry, University of Florida, Gainesville, FL, USA.
Firas KobeissyDepartment of Neurobiology, Neuroscience Institute, Morehouse School of Medicine, Atlanta, GA, USA.
Guangzheng CaiDepartment of Neurobiology, Neuroscience Institute, Morehouse School of Medicine, Atlanta, GA, USA.
Richard RubensteinDepartment of Neurology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
Kevin K W WangDepartment of Neurobiology, Neuroscience Institute, Morehouse School of Medicine, Atlanta, GA, USA.
John B WilliamsonDepartment of Psychiatry, University of Florida, Gainesville, FL, USA.
Claudia S RobertsonDepartment of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 770030, USA. claudiar@bcm.edu.ORCID http://orcid.org/0000-0002-8509-678X
Amy K WagnerDepartment of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.

Funding

U.S. Department of Defense W81XWH-19-2-0012U.S. Department of Defense W81XWH2211089U.S. Department of Veterans Affairs IK2RX002490
6 · The paper itself

Abstract

backgroundRecent studies demonstrate increased neurofilament light (NfL) levels across all types of traumatic brain injury (TBI). We evaluated inter-relationships between acute temporal NfL profiles with dynamic Intensive Care Unit (ICU) neurophysiological burden and tested the hypothesis that ICU burden is a significant, modifiable factor mediating NfL relationships to outcome.

methodsStored serum collected days 0-10 from 97 patients with severe TBI were analyzed. Temporal NfL patterns were examined using group-based trajectory (TRAJ) analysis. Mean NfL was calculated over days 0, 1-5, 6-10, and 0-10; ICU injury burden scores were generated using ridge regression associations with Glasgow Outcome Scale Extended (GOSE) over the same time-bins. We used univariable and multivariable regression to assess NfL TRAJ and mean values with respect to ICU injury burden, demographics, clinical factors, and outcome. NfL TRAJ and days 0-10 ICU injury burden were added to a baseline model to evaluate outcome discrimination. Multivariate mediation analysis was applied to assess the causal effects of ICU injury burden on NfL associations with GOSE.

resultsOf the patients, 63 had low NfL temporal profile, and 34 had higher profile (high-TRAJ). Individuals in the high-TRAJ group had lower Glasgow Coma Scale scores (GCSs), more frequently required barbiturate coma or decompressive surgery, and had worse 6-month outcomes. NfL means at all time epochs were significantly associated with unfavorable GOSE in univariate regression. In stepwise multivariate logistic regression, the area under the curve (AUC) increased progressively from ~ 0.74 to ~ 0.87 with the addition of computed tomography (CT) burden, NfL TRAJ, and ICU injury burden. NfL means and ICU injury burden were both negatively correlated with the initial GCS and positively correlated with CT burden, which was the most consistently significant baseline predictor. Covariate-adjusted mediation analysis suggests that ICU injury burden was a causal factor contributing to both CT burden and NfL-TRAJ associations with unfavorable GOSE.

conclusionsTemporal NfL profiles provide novel information about intracranial pathophysiology as a causal (and potentially modifiable) mediator of axonal injury following severe TBI. In conjunction with standard-of-care clinically derived metrics, NfL improved explanation of variance in outcomes.

Indexed as

Brain tissue oxygenationCerebral perfusion pressureCritical illnessIntracranial pressureNeurofilament lightTraumatic brain injury

Identifiers

PMID42443712

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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.