Evidence map›Paper›PMID 41787262›Full record

Observational studyThe journal of headache and pain2026

Serum and CSF neurofilament light chain and glial fibrillary acidic protein levels in idiopathic intracranial hypertension.

Nik Krajnc, Markus Ponleitner, Omar Keritam, Jan Philipp Nolte, Martin Bertich, Nina Müller, Christoph Stapf, Sina Zaic, Stefan Macher, Wolfgang Marik and 4 more

Abstract readObservational Study
In one paragraph

Observational study in The journal of headache and pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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

14 authors.

Nik KrajncDepartment of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Markus PonleitnerDepartment of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Omar KeritamDepartment of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Jan Philipp NolteDepartment of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Martin BertichDepartment of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Nina MüllerDepartment of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Christoph StapfDepartment of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Sina ZaicDepartment of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Stefan MacherDepartment of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Wolfgang MarikComprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
Klaus NovakComprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
Christian WöberDepartment of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Berthold Pemp *Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Gabriel Bsteh *Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria. gabriel.bsteh@meduniwien.ac.at.

Funding

Medical Scientific Fund of the Mayor of the City of Vienna Project 21009
6 · The paper itself

Abstract

backgroundIdiopathic intracranial hypertension (IIH) is a neurological disorder marked by increased intracranial pressure (ICP). Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are established biomarkers of neuroaxonal degeneration and astroglial activation that typically show strong serum-cerebrospinal fluid (CSF) concordance. However, their behaviour in IIH and the influence of increased ICP on CSF-serum relationship remains poorly understood. The aim of this study was to investigate serum and CSF NfL and GFAP levels in IIH, examine their CSF-serum coupling, and assess associations with ophthalmological outcomes.

methodsIn this prospective observational study, newly diagnosed people with IIH (pwIIH) underwent baseline serum and CSF sampling. NfL and GFAP levels were quantified using single-molecule array (Simoa→) technology, with age-, BMI-, and sex-adjustment. CSF-to-serum quotients (QNfL, QGFAP) and albumin-normalized indices were calculated. Outcome measures included: papilledema degree, visual acuity, perimetric mean deviation on automated perimetry, peripapillary retinal nerve fibre layer and macular ganglion cell layer thickness measured by optical coherence tomography, and arachnoid optic nerve sheath diameter measured by transbulbar sonography.

resultsThirty pwIIH (mean age 34.1 [SD 10.0], 100.0% female, mean CSF opening pressure [OP] 34.1 cmCSF [3.9], median BMI 35.4 kg/m2 [IQR 32.7–40.8]) were included. We did not observe any relevant associations between fluid biomarkers and ophthalmological outcomes at any time point. Notably, CSF NfL and GFAP levels did not correlate with respective serum levels. In contrast, serum NfL and GFAP levels were inversely associated with CSF OP, and QNfL and QGFAP showed positive associations with CSF OP (QNfL: β = 9.28; 95% CI 2.82, 15.73; p = 0.007; QGFAP: β = 13.00; 95% CI 0.12, 25.88; p = 0.048).

conclusionsNeither NfL nor GFAP levels seem particularly promising as biomarkers for prediction of ophthalmological outcomes in IIH. However, the observed dissociation between serum and CSF biomarkers supports altered CSF dynamics, rather than neuroaxonal or astrocytic injury, as the dominant pathophysiological drivers in the active phase of IIH.

Indexed as

Glial Fibrillary Acidic ProteinNeurofilament ProteinsPseudotumor CerebriAdultBiomarkersFemaleHumansMaleMiddle AgedProspective StudiesYoung AdultBiomarkersGFAP protein, humanGlial Fibrillary Acidic Proteinneurofilament protein LNeurofilament ProteinsBiomarker kineticsCerebrospinal fluidCSF dynamicsGlial fibrillary acidic proteinIdiopathic intracranial hypertensionSerum neurofilament light chain

Identifiers

PMID41787262
PMCPMC13085417

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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 Socratic graph.