Role of neurofilament light chain to reduce diagnosis and improve outcomes for patients in a real‐world cognitive neuropsychiatry service: A retrospective MiND study

Background It is common for patients presenting with neuropsychiatric symptoms to endure significant diagnostic odyssey. Neurofilament light chain (NfL) has shown promise in being able differentiate between neurodegenerative and psychiatric disorders. This study aimed assess the clinical utility of NfL avoiding misdiagnosis. Method In this retrospective study, we conducted file review assessed at Neuropsychiatry, Royal Melbourne Hospital 2009 2020. We included all (n = 212) who had a CSF level their baseline assessment. Investigators blinded levels extracted information including diagnoses from initial follow-up assessments using documentation available. addition, collected data external services where Initial follow-up/final were categorised as disorder (ND), (PSY), mild cognitive impairment (MCI), unclear, not-neurodegenerative (Not-ND). Not-ND individuals did not meet diagnosis PSY or MCI, have worsening symptoms. Based on our previous findings, defined an NfL>582pg/mL positive test result ND. Result So far, 135 patients. Of these, 14/89 (16%) initially diagnosed ND re-diagnosed Not-ND. 2/30 (7%) having Including MCI 32/135 (24%) delayed diagnosis, which could been reduced 14% based predicting Not-ND/MC/PSY. Data analysis ongoing full results will be presented conference. Conclusion Baseline aided clinicians real-world setting, reduce misdiagnosis, increase accuracy 76% 86%. An elevated prompt assertive investigations neurological causes. Conversely, low NfL, reassure against disorder, preventing unnecessary assessments. Timely accurate improve outcomes precision care families.