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- Title
Plasma glial fibrillary acidic protein and neurofilament light chain for the diagnostic and prognostic evaluation of frontotemporal dementia.
- Authors
Zhu, Nuole; Santos-Santos, Miguel; Illán-Gala, Ignacio; Montal, Victor; Estellés, Teresa; Barroeta, Isabel; Altuna, Miren; Arranz, Javier; Muñoz, Laia; Belbin, Olivia; Sala, Isabel; Sánchez-Saudinós, Maria Belén; Subirana, Andrea; Videla, Laura; Pegueroles, Jordi; Blesa, Rafael; Clarimón, Jordi; Carmona-Iragui, Maria; Fortea, Juan; Lleó, Alberto
- Abstract
Background: Astrocytes play an essential role in neuroinflammation and are involved in the pathogenesis of neurodenegerative diseases. Studies of glial fibrillary acidic protein (GFAP), an astrocytic damage marker, may help advance our understanding of different neurodegenerative diseases. In this study, we investigated the diagnostic performance of plasma GFAP (pGFAP), plasma neurofilament light chain (pNfL) and their combination for frontotemporal dementia (FTD) and Alzheimer's disease (AD) and their clinical utility in predicting disease progression. Methods: pGFAP and pNfL concentrations were measured in 72 FTD, 56 AD and 83 cognitively normal (CN) participants using the Single Molecule Array technology. Of the 211 participants, 199 underwent cerebrospinal (CSF) analysis and 122 had magnetic resonance imaging. We compared cross-sectional biomarker levels between groups, studied their diagnostic performance and assessed correlation between CSF biomarkers, cognitive performance and cortical thickness. The prognostic performance was investigated, analyzing cognitive decline through group comparisons by tertile. Results: Unlike pNfL, which was increased similarly in both clinical groups, pGFAP was increased in FTD but lower than in AD (all P < 0.01). Combination of both plasma markers improved the diagnostic performance to discriminate FTD from AD (area under the curve [AUC]: combination 0.78; pGFAP 0.7; pNfL 0.61, all P < 0.05). In FTD, pGFAP correlated with cognition, CSF and plasma NfL, and cortical thickness (all P < 0.05). The higher tertile of pGFAP was associated with greater change in MMSE score and poor cognitive outcome during follow-up both in FTD (1.40 points annually, hazard ratio [HR] 3.82, P < 0.005) and in AD (1.20 points annually, HR 2.26, P < 0.005). Conclusions: pGFAP and pNfL levels differ in FTD and AD, and their combination is useful for distinguishing between the two diseases. pGFAP could also be used to track disease severity and predict greater cognitive decline during follow-up in patients with FTD.
- Subjects
GLIAL fibrillary acidic protein; FRONTOTEMPORAL dementia; CYTOPLASMIC filaments; ALZHEIMER'S disease; MAGNETIC resonance imaging; MILD cognitive impairment
- Publication
Translational Neurodegeneration, 2021, Vol 10, Issue 1, p1
- ISSN
2047-9158
- Publication type
Article
- DOI
10.1186/s40035-021-00275-w