Abstract Details

Title Plasma Glial Fibrillary Acidic Protein (GFAP) as a Biomarker of Acute Focal Brain Injury

Topic Movement Disorders

Presentation(s) P3 - Poster Session 3 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-025

Objective This study aimed to assess plasma biomarker changes following an acute focal brain injury using Magnetic Resonance-guided High-Intensity Focused Ultrasound (MRgHIFU) thalamotomy.

Background

Biomarkers such as glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), amyloid-beta (Aβ40 and Aβ42), and phosphorylated tau 181 (pTau-181) have been proposed as indicators of acute brain injury. However, the validation of acute brain injury biomarkers has faced challenges, including the absence of pre-insult measurements, variability in injury timing and location, and interindividual differences. MRgHIFU thalamotomy, a precise technique used in patients with essential tremor (ET) and tremor-dominant Parkinson’s disease (TDPD), offers a controlled setting to study the relationship between focal brain injury and plasma biomarker changes.

Design/Methods This prospective study included 30 ET and TDPD patients undergoing MRgHIFU thalamotomy at a single academic institution. Blood samples were collected at three time points: preprocedure, 1 hour post-procedure, and 48 hours post-procedure. Plasma levels of GFAP, NfL, Aβ40 and Aβ42, and pTau-181 were measured using the Quanterix Single Molecule Arrays (SiMoA) assay.

Results GFAP levels significantly increased 48 hours post-MRgHIFU in all patients with a thalamotomy lesion. GFAP levels were highly sensitive (89.7%) and specific (96.6%) in detecting the presence of a HIFU lesion with a cutoff value of 216.2 pg/ml. NfL, Aβ40, and Aβ42, also showed statistically significant increases post-procedure but were less robust than GFAP. No changes were observed in pTau-181 levels post-MRgHIFU.

Conclusions Plasma GFAP emerged as a highly sensitive and reliable biomarker for detecting acute brain injury following MRgHIFU thalamotomy. The significant post-procedure GFAP increase suggests its potential as an early diagnostic tool for focal brain injuries, particularly in acute stroke. Further research is needed to validate the GFAP injury cutoff identified in this study and to explore its broader clinical utility in the early detection of focal brain lesions.

Authors/Disclosures
Nil Saez Calveras, MD (UT Southwestern Medical Center) PRESENTER	Dr. Saez Calveras has nothing to disclose.
Alexander Asturias, DO	Dr. Asturias has nothing to disclose.
James Yu, MD	Dr. Yu has nothing to disclose.
Barbara E. Stopschinski, MD (UT Southwestern Medical Center)	Dr. Stopschinski has nothing to disclose.
Jaime Vaquer-Alicea, PhD	Dr. Vaquer-Alicea has nothing to disclose.
Padraig E. O'Suilleabhain, MD, FAAN (UT Southwestern Medical Center)	The institution of Dr. O'Suilleabhain has received research support from ONO pharmaceutical. The institution of Dr. O'Suilleabhain has received research support from Integrated Research Laboratories.
Marc Diamond, MD (University of Texas, Southwestern Medical Center)	The institution of Dr. Diamond has received research support from NIH. Dr. Diamond has received intellectual property interests from a discovery or technology relating to health care.
Bhavya R. Shah, MD	Dr. Shah has received personal compensation in the range of $0-$499 for serving as a Consultant for Insightec.

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