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Nerve Injury and Regeneration / Eating Disorders and Behaviors / Autism Spectrum Disorder Research · Journal article
Translational Psychiatry · August 26, 2026
Encouraging direction, but not yet definitive.
This is a cohort study demonstrating that serum neurofilament light chain and GFAP are elevated in adolescents with anorexia nervosa compared to depression and other psychiatric disorders, with moderate discriminatory power (AUCs 0.70–0.84) and sNfL sensitivity to weight loss and treatment response. The findings suggest potential utility as biomarkers of neuroaxonal and astrocytic stress in pediatric psychiatry, particularly in AN, but clinical predictive or prognostic validity remains unestablished.
Cross-sectional and longitudinal cohort study. Adolescents with diagnosed anorexia nervosa, major depression, or other psychiatric disorders; specific eligibility criteria, age range, and recruitment setting not stated.. Intervention: Serum measurement of neurofilament light chain (sNfL) and glial fibrillary acidic protein (GFAP) using Single Molecule Array technology.. Compared with: Comparison across diagnostic groups (AN, depression, other psychiatric disorders) and against population norms via Z-score derived from reference datasets.. n = 412.
sNfL and GFAP levels significantly elevated in AN (sNfL: 1.15 ± 1.17; GFAP: 1.50 ± 0.84) versus depression (sNfL: 0.34 ± 1.10; GFAP: 0.58 ± 1.00) compared to population norms. Biomarker elevation in AN remained evident in sensitivity analysis restricted to underweight individuals with depression. sNfL correlated with baseline weight loss (β = -0.45, R² = 0.20) and declined significantly during AN treatment; GFAP changes were less pronounced.
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Clinicians should regard sNfL and GFAP as exploratory biomarkers of neuroaxonal and astrocytic stress in adolescent psychiatric illness, with potential utility in differential diagnosis between AN and depression. However, these markers are not ready for clinical adoption; their ability to guide treatment decisions, predict prognosis, or improve outcomes remains unproven and requires prospective validation in independent cohorts.
A well-designed cross-sectional and longitudinal study of biomarkers in a substantial adolescent psychiatric cohort with clear measurement and modest discriminatory power, but limited by single-centre design, surrogate endpoints, and lack of clinical outcome validation.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should regard sNfL and GFAP as exploratory biomarkers of neuroaxonal and astrocytic stress in adolescent psychiatric illness, with potential utility in differential diagnosis between AN and depression. However, these markers are not ready for clinical adoption; their ability to guide treatment decisions, predict prognosis, or improve outcomes remains unproven and requires prospective validation in independent cohorts.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (GFAP) are biomarkers of neuroaxonal and astrocytic damage but remain understudied in adolescent psychiatric populations. This study investigated sNfL and GFAP levels in 412 adolescents diagnosed with anorexia nervosa (AN) (n = 52), depression (n = 237), and other psychiatric disorders (n = 123). We assessed their diagnostic utility, correlation with disease severity, and longitudinal changes during AN treatment. Biomarkers were measured using Single Molecule Array technology, with Z-scores derived from reference datasets. Compared to population norms, both biomarkers were elevated in AN (sNfL: 1.15 ± 1.17; GFAP: 1.50 ± 0.84) and in depression (sNfL: 0.34 ± 1.10; GFAP: 0.58 ± 1.00). Patients with AN showed significantly higher biomarker levels than those with depression or other psychiatric disorders; importantly, this distinction remained evident in sensitivity analyses restricted to underweight individuals with depression. In AN, sNfL levels correlated with baseline weight loss (β = -0.45, R² = 0.20) and declined significantly during treatment, while GFAP changes were less pronounced. Neither marker correlated with depressive symptom severity. Bootstrapped ROC analyses showed moderate-to-good discriminatory power (AUCs 0.70-0.84) for distinguishing AN from depression. These findings suggest that neuroaxonal and astrocytic stress is a component of adolescent psychopathology, particularly in AN. sNfL appears sensitive to starvation-related neurobiological changes, with levels normalizing alongside weight restoration. GFAP showed similar but less robust trends. Accordingly, the observed biomarker changes reflect more than underweight alone, supporting a potential role in differential diagnosis and treatment monitoring.
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