• Alberto Benussi, Nicholas J Ashton, Thomas K Karikari, Stefano Gazzina, Enrico Premi, Luisa Benussi, Roberta Ghidoni, Juan Lantero Rodriguez, Andreja Emeršič, Giuliano Binetti, Silvia Fostinelli, Marcello Giunta, Roberto Gasparotti, Henrik Zetterberg, Kaj Blennow, and Barbara Borroni.
• Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
• J. Alzheimers Dis. 2020 Jan 1; 77 (3): 1129-1141.

BackgroundIt is still unknown if serum glial fibrillary acidic protein (GFAP) is a useful marker in frontotemporal lobar degeneration (FTLD).ObjectiveTo assess the diagnostic and prognostic value of serum GFAP in a large cohort of patients with FTLD.MethodsIn this retrospective study, performed on 406 participants, we measured serum GFAP concentration with an ultrasensitive Single molecule array (Simoa) method in patients with FTLD, Alzheimer's disease (AD), and in cognitively unimpaired elderly controls. We assessed the role of GFAP as marker of disease severity by analyzing the correlation with clinical variables, neurophysiological data, and cross-sectional brain imaging. Moreover, we evaluated the role of serum GFAP as a prognostic marker of disease survival.ResultsWe observed significantly higher levels of serum GFAP in patients with FTLD syndromes, except progressive supranuclear palsy, compared with healthy controls, but not compared with AD patients. In FTLD, serum GFAP levels correlated with measures of cognitive dysfunction and disease severity, and were associated with indirect measures of GABAergic deficit. Serum GFAP concentration was not a significant predictor of survival.ConclusionSerum GFAP is increased in FTLD, correlates with cognition and GABAergic deficits, and thus shows promise as a biomarker of disease severity in FTLD.

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