Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2026 02 04 1 12 Guimin Zheng Department of General Medicine, Hebei General Hospital, Shijiazhuang, Hebei Province, China Lei Wang Department of Medical Imaging, Hebei General Hospital, Shijiazhuang, Hebei Province, China Jingjing Cao Department of General Medicine, Hebei General Hospital, Shijiazhuang, Hebei Province, China Xiao Zheng Department of Rheumatology, Hebei General Hospital, Shijiazhuang, Hebei Province, China 2025 08 13 2025 11 05 Cognitive dysfunction (CD) is a common neuropsychiatric manifestation of systemic lupus erythematosus (SLE), but its early identification lacks objective serological markers. This study aimed to explore the predictive value of combined serum interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), and neurofilament light chain (NfL) for CD in SLE patients. A total of 108 SLE patients (January 2018–December 2019) and 50 healthy controls were enrolled. SLE patients were divided into CD group (MoCA score <26, n=49) and non-CD group (MoCA score ≥26, n=59). Serum IL-6, ICAM-1, and NfL levels were detected by ELISA. Logistic regression and ROC curve analyses were performed to evaluate risk factors and predictive efficacy. Serum IL-6, ICAM-1, and NfL levels were significantly higher in SLE patients than in controls (p<0.05), and further elevated in the CD group. These three markers were independent risk factors for SLE-related CD. The AUC of combined detection (0.852) was significantly higher than individual markers (0.734, 0.712, 0.677). Serum IL-6, ICAM-1, and NfL have certain predictive value for CD in SLE patients, and the combined detection of these three indicators offers higher predictive value. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4551 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4551/2295