Reassessing metrics: The limitations of brain function as indicators of brain health

Authors

  • Umema Zafar Khyber Medical College
  • Syed Hamid Habib
  • Muhammad Omar Malik KHYBER MEDICAL UNIVERSITY

DOI:

https://doi.org/10.12669/pjms.41.8.12154

Keywords:

Brain health, neuro-biomarkers, brain functions, Neurofilament light, Neuron Specific Enolase, Phosphorylated Tau proteins, cognition, emotional wellbeing, hearing, vision, motor fucntion

Abstract

Objective: This study aimed to evaluate brain health using cognition, vision, hearing, emotional well-being, aging, and motor function as predictors, with blood neurofilament light (NfL), neuron-specific enolase (NSE), and phosphorylated tau (pTau) as response variables for detecting chronic brain injury.

Methodology: This is a predictive cross-sectional modelling study carried out in various settings across Peshawar, Pakistan in which a total of 75 healthy adults were included from May 2022 to February 2023. Various tests were performed including visual fields, audiometry, dynamometry, Mini-Mental State Examination (MMSE), and Trait Emotional Intelligence Questionnaire (TEIQue-SF). Serum levels of NfL, pTau, and NSE were measured via ELISA and multiple linear regression models were developed. These biomarkers were selected based on a preliminary scoping review.

Results: Statistically significant discrepancies were present between predicted and actual biomarker values (NfL: actual 0.026±0.011 ng/ml vs. predicted 0.001±0.000 ng/ml, p<0.001; NSE: actual 10.46±1.52 ng/ml vs. predicted 4.127±1.8 ng/ml, p<0.001; pTau: actual 4.48±3.23 ng/ml vs. predicted 1.027±0.85 ng/ml, p<0.001), indicating poor prediction model performance. The k-fold cross-validation confirmed this, with over 2% deviation in all subsets.

Conclusion: Brain health prediction models based solely on neuro-biomarkers and brain function parameters may not generalize well to healthy populations, indicating the need for additional factors influencing brain health.

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Published

2025-08-01

How to Cite

Zafar, U., Habib, S. H., & Malik, M. O. (2025). Reassessing metrics: The limitations of brain function as indicators of brain health. Pakistan Journal of Medical Sciences, 41(8), 2355–2361. https://doi.org/10.12669/pjms.41.8.12154

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Section

Original Articles