Plasma Neurofilament Light Chain as a Marker of Axonal Injury in Traumatic Brain Injury
DOI:
https://doi.org/10.5281/zenodo.22310509Keywords:
Neurofilament light chain, Traumatic brain injury, Axonal injury, BiomarkerAbstract
Background: Traumatic brain injury (TBI) spans concussion to severe injury, and axonal shearing is a shared pathway across
this spectrum. Neurofilament light chain (NfL), an axonal protein, enters blood after axonal damage and is now measurable with
ultrasensitive digital immunoassays. Objective: To synthesise published evidence on plasma NfL as a marker of axonal injury across the TBI severity spectrum. Methods: Narrative review of cohort studies, comparative biomarker studies, imaging-correlation studies and methodological reports. Findings: Plasma NfL rises with injury severity, stays elevated longer than glial markers, correlates with diffusion imaging abnormalities, and predicts long-term outcome and progressive neurodegeneration. In sport-related concussion, NfL distinguishes injured athletes from controls and tracks recovery time. Age, renal function and neurological comorbidity confound
interpretation, and NfL lacks injury-type specificity. Conclusions: Plasma NfL is a promising, non-specific axonal injury marker complementing glial biomarkers, with growing but still incomplete evidence supporting clinical translation.
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