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GFAP: Marker of Brain Injury in Acute Mild TBI

Neurology; ePub 2018 Sept 12; Gill, Latour, et al

A recent study confirms glial fibrillary acidic protein (GFAP) as a promising marker of brain injury in patients with acute mild traumatic brain injury (mTBI). A combination of various biomarkers linked to different pathophysiologic mechanisms increases diagnostic subgroup accuracy. Study participants presented to the emergency department with suspected mTBI (n=277) with a CT and MRI scan and healthy controls (n=49). Plasma concentrations of tau, GFAP, ubiquitin carboxyl-terminal hydrolase L1, and neurofilament light chain (NFL) were measured using the single-molecule array technology. Researchers found:

  • Concentrations of GFAP, tau, and NFL were higher in patients with mTBI, compared with those of controls.
  • GFAP yielded an area under the curve (AUC) of 0.93, confirming its discriminatory power for distinguishing mTBI from controls.
  • Levels of GFAP, tau, and NFL were higher in patients with trauma-related intracranial findings on CT compared with those with normal CT, with the only significant predictor being GFAP (AUC 0.77).
  • Among patients with mTBI, tau, NFL, and GFAP differentiated subjects with and without MRI abnormalities with an AUC of 0.83, with GFAP being the strongest predictor.
Citation:

Gill J, Latour L, Diaz-Arrastia R, et al. Glial fibrillary acidic protein elevations relate to neuroimaging abnormalities acutely following a mild traumatic brain injury. [Published online ahead of print September 12, 2018]. Neurology. doi:10.1212/WNL.0000000000006321.