Peripheral blood biomarkers and mild behavioral impairment in mild cognitive impairment: Clinical correlations and mechanistic insights

Table 1 Core mild behavioral impairment domain and associated biomarkers

MBI behavioral domain	Typical symptoms	Peripheral blood biomarkers	Pathological mechanism	Ref.
Impulse control disorder	Compulsive spending, aggressive speech	GFAP, NFL	Astrocyte activation → neuroinflammation → disruption of prefrontal inhibitory function	[9,16]
Apathy	Reduced goal-directed behavior	YKL-40	Blood-brain barrier disruption → central inflammation → dopaminergic pathway degeneration	[17,18]
Emotional dysregulation	Depression, anxiety	P-tau181, P-tau217	Tau protein pathology → neurotransmitter imbalance in limbic system	[19-21]
Oxidative stress-related	Cognitive-behavioral vicious cycle	MDA, SOD	Free radical damage → neuronal dysfunction → exacerbation of neuroinflammation	[22]

GFAP: Glial fibrillary acidic protein; MBI: Mild behavioral impairment; MDA: Malondialdehyde; NFL: Neurofilament light; P-tau: Phosphorylated tau; SOD: Superoxide dismutase; YKL-40: Chitinase-3-like 1.