# Tracking Preeclampsia: The Role of Cerebral Biomarkers—A Narrative Review

## TL;DR

This review examines how brain-related biomarkers like NfL, NSE, S100B, and Tau can help track cerebral complications in preeclampsia.

## Contribution

The paper highlights NfL as a novel and promising biomarker for assessing brain injury and severity in preeclampsia.

## Key findings

- Plasma levels of NfL, NSE, S100B, and Tau are elevated in preeclamptic pregnancies.
- NfL shows the strongest link to blood-brain barrier dysfunction and cognitive symptoms.
- Variations in biomarker levels suggest impaired blood-brain barrier integrity rather than CNS overproduction.

## Abstract

Preeclampsia (PE) is the onset of hypertension in pregnancy with systemic involvement; PE poses significant risks of cerebral complications, including eclampsia and long-term cognitive impairment. This review explores the potential of neurological biomarkers—neurofilament light chain (NfL), neuron-specific enolase (NSE), S100 Calcium Binding Protein B (S100B), and tau—as indicators of cerebral injury in PE. A literature search identified studies comparing biomarker levels in preeclamptic and healthy pregnancies. Findings reveal elevated plasma levels of NfL, NSE, S100B, and Tau in PE, with NfL showing the strongest association with blood–brain barrier dysfunction, cognitive symptoms, and disease severity. Variations between plasma and cerebrospinal fluid levels suggest impaired BBB integrity rather than increased central nervous system production. Despite promising correlations, limitations include small sample sizes, lack of standardized thresholds, and limited CSF data. While NfL emerges as a particularly promising marker for risk stratification, further research is needed to validate the clinical utility of these biomarkers in routine PE management.