Neurofilament light chain (NfL) is an emerging biomarker of neural degeneration. NfL is an integral component of axons and is released into the bloodstream and cerebrospinal fluid during neurodegeneration; hence it can be used to monitor disease progression. Given that several neurological disorders are accompanied by cognitive decline, recent literature has investigated the relationship between NfL levels and cognition. The objective of this scoping review was to determine whether a consistent relationship between NfL and cognition exists in the context of variable degrees of neurodegeneration present across several neurological disorders. Four electronic databases were searched for relevant articles and 160 articles were initially identified. After article screening, 37 studies met the final inclusion criteria. Studies were then qualitatively synthesized to determine the relationship between NfL and cognition across a variety of neurological disorders. The large majority of studies found that NfL levels are inversely correlated with cognition, such that higher NfL levels are associated with poorer cognition. This relationship was not universal, however, and this discrepancy was speculated to be due to the nature of the neurological disorder, individual differences between participants, or methodological inconsistencies. Further study is required, and associated recommendations were proposed for the design of future investigations.
Multiple sclerosis (MS) can be associated with social cognition deficits. Metformin, a drug used to treat type II diabetes mellitus (DMII) improves social cognition in mice by repressing monoacylglycerol lipase (MgII) in the brain. Social cognition was compared in people with MS (PwMS) and comorbid DMII who are and who are not treated with metformin. We recruited 22 individuals with MS and DMII, and 17 matched healthy controls to establish baseline levels of the outcome measures. Differences were assessed in social cognitive outcomes and MgII levels between metformin and nonmetformin, and healthy control groups. Mgll levels were lowest in the metformin group, although differences were not statistically significant. There were no social cognition differences between the metformin and nonmetformin groups, but the MS group overall performed worse than controls on certain social cognition domains. Implications of these results are reported, with suggestions for future social cognition and MS investigations.
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