Serum Neurofilament Light Chain as an Independent Biomarker of Axonal Damage of Psychiatric Burden in Multiple Sclerosis
DOI:
https://doi.org/10.54133/ajms.v10i2.2675Keywords:
Anxiety, Biomarkers, Depression, Expanded Disability Status Scale (EDSS), Multiple sclerosis, Neurofilament light chainAbstract
Background: Multiple sclerosis (MS) is a chronic neuroinflammatory disorder associated with neurological disability and psychiatric comorbidity. Serum neurofilament light chain (sNfL) is a biomarker of axonal injury, yet its relationship with psychiatric symptoms in MS is unclear. Objective: To assess depression and anxiety prevalence in Iraqi MS patients and the associations with sNfL. Methods: A cross-sectional case–control study was conducted at the MS Consultation Clinic, Iraqi Medical City, Baghdad (October 2024–January 2025). Depression and anxiety were evaluated with the Hospital Anxiety and Depression Scale (HADS), disability with the Expanded Disability Status Scale (EDSS), and sNfL with Enzyme-Linked Immunosorbent Assay (ELISA). Results: A total of 150 MS patients and 50 healthy subjects (controls) were enrolled. Depression and anxiety were evaluated with the Hospital Anxiety and Depression Scale (HADS), disability with the Expanded Disability Status Scale (EDSS), and serum NfL with ELISA. MS patients had significantly higher depression (31.3%) and anxiety (14.7%) than controls (4.0% and 10.0%; p<0.001). Depression correlated with lower socioeconomic and educational status, while female sex and marital status predicted higher anxiety. Median sNfL levels were elevated in MS (169.6 vs. 98.9 pg/mL; p<0.001) but showed only a weak negative correlation with depression (r= –0.174, p=0.034). Conclusions: Depression and anxiety are prevalent in Iraqi MS patients and strongly linked to sociodemographic and disability measures. While NfL, as a marker of axonal injury, had limited value for detecting psychiatric comorbidity, emphasizing the need for integrated neurological and mental health care.
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