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Assessing Brain Injury After Extra-Axial Brain Tumor Resection: Circulating Neurofilament Light Levels, Neurological
Isak Michaëlsson1,2, Tobias Hallén1,2, Dan Farahmand1,2
1Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg , Sweden.
Neurosurgery
|July 10, 2025
Summary
Plasma neurofilament light chain (NfL) levels can indicate structural brain damage after extra-axial tumor surgery. Elevated NfL levels correlate with new neurological deficits but not with postoperative fatigue.
Area of Science:
- Neurosurgery
- Neurology
- Biomarker Research
Background:
- Circulating brain-injury biomarkers are increasingly studied using ultrasensitive techniques.
- Neurofilament light chain (NfL) is an axonal injury biomarker quantifiable via blood sampling.
Purpose of the Study:
- To explore relationships between plasma NfL levels and postoperative outcomes in patients undergoing extra-axial brain tumor surgery.
- To assess associations with new neurological deficits and fatigue.
- To establish the temporal profile of NfL level changes post-surgery.
Main Methods:
- Prospective study of 41 adult patients undergoing surgery for meningiomas or vestibular schwannomas.
- Plasma NfL measured pre-surgery and on postoperative days 1, 10, 30, and 60.
- New neurological deficits assessed on day 1 post-surgery; fatigue measured pre-surgery and 6 months post-surgery.
Main Results:
- NfL levels peaked on postoperative day 10.
- Higher NfL levels on days 10, 30, and 60 were associated with new neurological deficits.
- NfL levels at day 10 showed the highest sensitivity and specificity for predicting new neurological deficits.
- No association was found between postoperative NfL levels and fatigue.
Conclusions:
- Plasma NfL measurement is a promising tool for quantifying structural brain damage after extra-axial tumor surgery.
- Elevated NfL levels are linked to neurological deficits but not to postoperative fatigue.
