NEUROFILAMENT LIGHT CHAIN AS A POTENTIAL INDICATOR OF DELIRIUM TREMENS AMONG PATIENTS WITH ALCOHOL DEPENDENCE

Delirium tremens (DTs) is the most serious complication of alcohol withdrawal syndrome in patients with alcohol dependence (AD) as it is associated with high risk of mortality rate if not recognized promptly and treated adequately. Neurofilament light chain (NFL), as a measure of neuroaxonal injury, has recently gained attention in AD(Huang et al., 2023). However, whether NFL level differs between patients with and without DTs has not been explored yet.

We compared the blood NFL levels between patients with AD who had experience of DTs and those did not to test the hypothesis that NFL can identify the patients with AD to develop DTs.

224 inpatients fulfilled the DSM-IV-TR criteria for AD and 116 healthy controls were enrolled. Patients with AD were divided by the appearance of DTs into the DT group (n = 25) and non-DT group (n = 199). Blood levels of NFL were measured by Ella microfluid platform analysis. We performed the receiver operating characteristic (ROC) analysis to determine the possibility of NFL level to discriminate individuals with DTs.

Serum NFL levels differed significantly among the three groups, with highest in the DT group (63.1 ± 47.2 pg/mL), followed by non-DT group (24.0 ± 22.4 pg/mL) and then control group (11.8 ± 6.1 pg/mL) (p <0.0001). In addition, the ROC curve revealed that an NFL level of 31.2 pg/mL could significantly differentiate DTs group from non-DT group (sensitivity: 80.0%; specificity: 76.9%; area under the curve: 0.84; p <0.001; 95% Confidence Intervals for the AUC: 0.77-0.91).

Our study revealed the patients with AD experiencing DTs had a significantly higher NFL level, compared to those without such experiences. This result indicate the NFL can be an indicator of delirium tremens in patients with alcohol dependence.Furthermore, the pronounced increase of NFL levels in the patients with AD warrants further investigation of a potential neuroaxonal vulnerability of patients with AD to the development of DTs.

HUANG, M. C., TU, H. Y., CHUNG, R. H., KUO, H. W., LIU, T. H., CHEN, C. H., MOCHLY-ROSEN, D. &LIU, Y. L. 2023. Changes of neurofilament light chain in patients with alcohol dependence following withdrawal and the genetic effect from ALDH2 Polymorphism. Eur Arch Psychiatry Clin Neurosci.