Abstract Details

Title Utility of Neurofilament Light Chain in Assessment of Neurocysticercosis in Lusaka, Zambia

Topic Infectious Disease

Presentation(s) S25 - Diagnostics and Therapies in Infectious Diseases (4:54 PM-5:06 PM)

Poster/Presentation
Number 008

Background Neurocysticercosis is one of the most common causes of epilepsy in low- and middle-income countries. However, little is known regarding optimal diagnostic tests for this condition, especially in resource-limited settings where access to neuroimaging is often limited. NFL is a marker of central neuronal damage. Studies have suggested that it may have clinical utility in diagnosing other neurological conditions marked by this damage, but its relationship with NCC is unknown.

Objective

1. Determine whether neurofilament light chain (NFL) serum concentration is higher in people with neurocysticercosis (NCC) than in those with other causes of focal epilepsy.

2. Determine whether NFL concentration is higher in people with neurocysticercosis with an abnormal EEG than in people with neurocysticercosis with a normal EEG.

Design/Methods

A prospective case-control study with cross-sectional evaluation of diagnostic testing was conducted among consenting adults seen at the main referral center in Lusaka, Zambia from January 2022 to October 2023. Cases were defined as those participants with untreated NCC with active lesions on head CT or MRI, regardless of clinical presentation. Controls were adults with new-onset focal epilepsy within the previous six months and no evidence of NCC on neuroimaging. Demographic and clinical details were captured, and participants underwent routine EEG and blood collection for serum NFL concentrations using ELISA assays. Wilcoxon rank sum tests were used to compare means between groups.

Results 34 cases and 32 controls had NFL data available. Mean NFL concentration was significantly higher in controls than in cases (361.3 vs. 54.1 pg/mL, p=0.0031). Among those with NCC, NFL concentration was significantly higher in those with an abnormal EEG (114.6 vs. 36.3 pg/mL, p=0.0029).

Conclusions Among those with NCC, NFL concentration is significantly higher in those with an abnormal EEG, suggesting it may be a promising biomarker of seizure propensity amongst people with NCC.

Authors/Disclosures
Kristen Sportiello PRESENTER	The institution of an immediate family member of Ms. Sportiello has received research support from National Institutes of Health (NIH). An immediate family member of Ms. Sportiello has received personal compensation in the range of $50,000-$99,999 for serving as a Research Assistant with National Institutes of Health (NIH).
Claudia Gambrah-Lyles, MD	Dr. Gambrah-Lyles has nothing to disclose.
Mashina Chomba, MBChB (University of Zambia)	Dr. Chomba has nothing to disclose.
Melody T. Asukile, MBBS (University Teaching Hospital)	Dr. Asukile has received research support from Royal Society for Tropical Medicine and Hygiene. Dr. Asukile has received personal compensation in the range of $0-$499 for serving as a meeting speaker with American Neurological Association.
Caroline Kabwe	No disclosure on file
Deanna Saylor, MD, MHS (Johns Hopkins Hospital)	The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from National Multiple Sclerosis Society. The institution of Dr. Saylor has received research support from American Academy of Neurology. The institution of Dr. Saylor has received research support from United States Department of State. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and Educational Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.
David Bearden, MD (University of Rochester School of Medicine)	Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis. Dr. Bearden has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for law firms.