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Journalism of Courage
Could a simple blood test give people a warning about brain diseases years before symptoms show up? Neurosurgeon Dr Jay Jagannathan recently raised this question on Instagram, asking his followers: “Would you take this test if it could give you a warning sign years before symptoms?”
In his post, he highlighted the Neurofilament Light Chain (NfL) test as a potential game-changer. “Neurofilament light chain (NfL) — a marker of nerve cell injury — is emerging as one of the most powerful predictors of brain health. Elevated levels are linked to Alzheimer’s, Parkinson’s, multiple sclerosis, stroke, and even traumatic brain injury.” What makes it significant, he explained, is that “you could feel ‘fine’… but NfL can already be sounding the alarm. Why it matters: nerve cells don’t repair easily. Elevated NfL means silent but ongoing brain damage — long before symptoms appear.”
He also described how the test works: “What the test is: the serum/plasma NfL test is a simple blood draw. It measures tiny protein fragments (NfL) released when brain or spinal cord cells are damaged. Normally, these proteins stay inside neurons. When neurons are injured, they leak into the blood and spinal fluid, where we can measure them.” According to him, doctors may use NfL trends as a red flag or to track disease progression even before an MRI picks up changes.
Alongside this, Dr Jagannathan stressed prevention, advising people to control blood pressure and blood sugar, sleep 7–8 hours, move daily, eat a Mediterranean-style diet, avoid smoking and excess alcohol, and manage stress. He concluded with a clear reminder: “Brain damage is often silent — until it isn’t. Don’t wait for symptoms. Ask your doctor about NfL testing if you’re at risk or have a family history of neurological disease.”
Dr Jagdish Chattnalli, senior minimal invasive brain and spine surgeon, Bengaluru West Clinics, HCG Hospitals Bengaluru, tells indianexpress.com, “Elevated neurofilament light chain reflects neuronal injury and is one of the most sensitive blood markers we have for ongoing brain damage. It is particularly useful as a prognostic indicator because higher levels are consistently associated with faster decline or a greater likelihood of conversion to symptomatic disease in several disorders, including Parkinson’s disease and Alzheimer’s-related syndromes.”
However, he notes that NfL is not disease-specific. “A raised value tells us that neurons are being damaged, but it does not by itself identify the cause or give a firm diagnosis. In practice, the best use of NfL is as part of a broader assessment that includes clinical evaluation, imaging, and other biomarkers.”
The assay itself is a straightforward blood test, Dr Chattnalli notes, and modern high-sensitivity platforms make it possible to measure very low levels reliably. Commercial laboratories and reference centres now offer NfL testing, and validated assays are available from major providers. That said, routine population screening is not the current practice. NfL testing is most valuable when ordered by a clinician who can interpret the result alongside symptoms, imaging, and other tests.
“I would recommend testing in people who have concerning symptoms or objective findings on examination or imaging, and in individuals with strong family history or other clear risk factors, where knowing the trajectory of neuronal injury would change management,” mentions the experts.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
