ArticleEpilepsia2026
Serum NfL, GFAP, and p-tau217 in adults with drug-resistant epilepsy and intellectual disabilities: Signs of ongoing neural injury.
Article in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveAdults with epilepsy and intellectual disabilities (IDs) may be at increased risk of dementia, but clinical evaluation is complex and use of conventional biomarkers is often considered too invasive. We explored abnormality of serum neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and phosphorylated tau-217 (p-tau217) in these adults, and their associations with clinical outcomes.
methodsSerum biomarker levels were quantified with Single Molecule Array (Simoa) in 68 adults with co-occurring epilepsy and ID at a median age of 52.0 (range 24-76) years. Levels were classified normal/abnormal (>95th percentile) in comparison to reference data of age-matched healthy controls (NfL, GFAP) or Alzheimer's disease (AD)-specific cutoff (p-tau217). Associations with age were assessed with correlations and segmented regression analyses. Associations with adaptive decline, suspected dementia, ID, epilepsy, antiseizure medication, comorbidity, and mortality were explored using chi-square tests, Mann-Whitney U tests, log rank tests, and Cox regression analyses.
resultsNfL levels were abnormal in 51.5%, GFAP in 63.2%, and p-tau217 in 2.9%. Age-corrected Z-scores of NfL were still significantly associated with age (r = .31, p = .01). Elevated NfL was associated with significant adaptive decline (χ SIGNIFICANCE: NfL and GFAP were abnormal in many participants, coinciding with clinical decline. Findings are suggestive for ongoing neural injury, but not necessarily for AD.
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