Plasma neurofilament light chain protein is not increased in forensic psychiatric populations: a pilot study

Anja Fernqvist; Eirini Alexiou; Henrik Zetterberg; Katarina Howner; Thomas Nilsson; Peter Andiné

doi:10.3389/fpsyt.2023.1176266

Plasma neurofilament light chain protein is not increased in forensic psychiatric populations: a pilot study

Front Psychiatry. 2023 May 4:14:1176266. doi: 10.3389/fpsyt.2023.1176266. eCollection 2023.

Authors

Anja Fernqvist^{1

2}, Eirini Alexiou^{1

3}, Henrik Zetterberg^{4

5

6

7

8

9}, Katarina Howner^{2

10}, Thomas Nilsson^{1

3}, Peter Andiné^{1

2

3}

Affiliations

¹ Center for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
² Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden.
³ Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁴ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
⁵ Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
⁶ Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom.
⁷ UK Dementia Research Institute, University College London, London, United Kingdom.
⁸ Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, Hong Kong SAR, China.
⁹ Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.
¹⁰ Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.

Abstract

Introduction: Neurofilament light chain protein (NfL) is a fluid biomarker of neural injury measurable in cerebrospinal fluid and blood. Patients with different neurodegenerative disorders and mild traumatic brain injury display elevated levels of NfL. However, so far, elevated levels of NfL have not been demonstrated in persons with psychiatric disorders. To our knowledge, the occurrence of NfL in the blood has not previously been studied in persons undergoing forensic psychiatric assessment or persons treated in forensic mental health services. Supposedly, these persons suffer from experiences and conditions with a higher risk of neural injury than other psychiatric patients.

Methods: In this pilot study, we investigated plasma levels of NfL in 20 persons undergoing forensic psychiatric assessment and 20 patients at a forensic psychiatric hospital. NfL values were compared with control groups of healthy individuals matched for age and sex.

Results: The prevalence of increased NfL in both forensic groups was low and did not differ compared with the controls. However, some persons undergoing forensic psychiatric assessment showed slightly elevated values.

Discussion: The slightly elevated values were observed in the group investigated closer in time to the index crime, when elevated NfL levels could be expected to be more prevalent due to acute conditions from the time of the offense. This gives reason to look further into this group.

Keywords: biomarker; forensic psychiatry; neural injury; neurofilament; psychosis.