Neopterin and neurophysiological measurements as markers of anxiety and stress

Abstract

Background: Mental health is an increasing global crisis. It has large social, economic, and health costs, with stress and anxiety disorders accounting for a large portion of the impact. Biomarkers may help to improve the understanding and management of mental health conditions.

Aim: The aim of this study was to investigate whether neopterin and certain neurophysiological measures could be used as complementary markers for stress and anxiety symptoms as determined by the Depression, Anxiety, and Stress Scale (DASS-21).

Methods: A sample cohort of 158 respondents completed the DASS-21 and biographical questionnaire, which were used to stratify Health Science university students between Group A (n=20), who had high levels of symptoms, and Group B (n=20) who had normal levels of stress and anxiety. Neurophysiological measurements were taken from these participants, namely heart rate variability (HRV), blood pressure (BP), blood-volume pulse (BVP), electrodermal activity (EDA), and quantitative electroencephalography (qEEG). The participants also donated a urine sample which was tested for neopterin concentration (a non-specific biomarker of inflammation) using an enzyme-linked immunosorbent assay (ELISA).

Results & Discussion: Neopterin positively correlated with the stress and anxiety scores, while HRV and BVP were negatively correlated with these scores. In terms of qEEG, delta and hibeta wave activity increased in the left and frontal brain regions in participants with high mental health scores, whereas alpha wave activity decreased in these regions. High DASS scores were associated with elevated neopterin concentration and neurophysiological changes (brain waves, HRV, and BVP).

Conclusion: The associations between inflammation, neurophysiology, and mental health need to be addressed and further investigated to mitigate further health and economic burden.