Investigation of the association of serum GFAP and NfL with brain and upper cervical MRI volumes in AQP4-IgG-positive NMOSD and MOGAD

Background: Serum glial fibrillary acidic protein (sGFAP) is associated with disease activity in aquaporin-4-immunoglobulin G-seropositive neuromyelitis optica spectrum disorders (AQP4-IgG+NMOSD). Serum neurofilament light chain (sNfL) is a biomarker for neuroaxonal damage. However, the association...

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Main Authors: Patrick Schindler, Ulrike Grittner, Rebekka Rust, Susanna Asseyer, Judith Bellmann-Strobl, Tanja Schmitz-Hübsch, Michael Scheel, Sven Jarius, Brigitte Wildemann, Markus Reindl, Pascal Benkert, Jens Kuhle, Friedemann Paul, Klemens Ruprecht, Claudia Chien
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Therapeutic Advances in Neurological Disorders
Online Access:https://doi.org/10.1177/17562864251345792
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author Patrick Schindler
Ulrike Grittner
Rebekka Rust
Susanna Asseyer
Judith Bellmann-Strobl
Tanja Schmitz-Hübsch
Michael Scheel
Sven Jarius
Brigitte Wildemann
Markus Reindl
Pascal Benkert
Jens Kuhle
Friedemann Paul
Klemens Ruprecht
Claudia Chien
author_facet Patrick Schindler
Ulrike Grittner
Rebekka Rust
Susanna Asseyer
Judith Bellmann-Strobl
Tanja Schmitz-Hübsch
Michael Scheel
Sven Jarius
Brigitte Wildemann
Markus Reindl
Pascal Benkert
Jens Kuhle
Friedemann Paul
Klemens Ruprecht
Claudia Chien
author_sort Patrick Schindler
collection DOAJ
description Background: Serum glial fibrillary acidic protein (sGFAP) is associated with disease activity in aquaporin-4-immunoglobulin G-seropositive neuromyelitis optica spectrum disorders (AQP4-IgG+NMOSD). Serum neurofilament light chain (sNfL) is a biomarker for neuroaxonal damage. However, the association of sGFAP and sNfL with magnetic resonance imaging (MRI) volumes in AQP4-IgG+NMOSD is unclear. Objectives: To investigate the associations of sGFAP and sNfL with brain MRI volumes in AQP4-IgG+NMOSD. Design: Monocentric, retrospective, observational study. Methods: In 33 clinically stable patients with AQP4-IgG+NMOSD, 17 patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and 15 healthy controls (HC), sGFAP and sNfL were measured at 2 (HC = 1) and 3-Tesla MRIs were obtained at 4 (HC = 1) yearly visits. Associations between biomarkers and MRI metrics were evaluated using linear models. Results: In AQP4-IgG+NMOSD, but not in MOGAD and HC, higher sGFAP was associated with lower hippocampus (β = −2.0 (95% confidence interval: −3.4, −0.7), p  = 0.004) and thalamus volumes (β = −2.5 (−4.3, −0.7), p  = 0.006) and higher MRI cerebrospinal fluid volume (β = 1.8 (0.7, 3.2), p  = 0.01), and, statistically less robust, with lower whole brain (β = −2.3 (−5.3, 0.8), p  = 0.15) and gray matter volumes (β = −1.8 (−4.0, 0.4), p  = 0.10). Furthermore, higher sGFAP (β = −0.06 (−0.11, −0.002), p  = 0.04), but not sNfL (β = −0.02 (−0.08, 0.03), p  = 0.38), was associated with percent brain volume change in AQP4-IgG+NMOSD. Conclusion: The specific associations of sGFAP with brain MRI volumes corroborate sGFAP as a biomarker for disease activity in AQP4-IgG+NMOSD.
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series Therapeutic Advances in Neurological Disorders
spelling doaj-art-85c74664d69140c9b4baa9edc4df5b2b2025-08-20T03:51:14ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642025-07-011810.1177/17562864251345792Investigation of the association of serum GFAP and NfL with brain and upper cervical MRI volumes in AQP4-IgG-positive NMOSD and MOGADPatrick SchindlerUlrike GrittnerRebekka RustSusanna AsseyerJudith Bellmann-StroblTanja Schmitz-HübschMichael ScheelSven JariusBrigitte WildemannMarkus ReindlPascal BenkertJens KuhleFriedemann PaulKlemens RuprechtClaudia ChienBackground: Serum glial fibrillary acidic protein (sGFAP) is associated with disease activity in aquaporin-4-immunoglobulin G-seropositive neuromyelitis optica spectrum disorders (AQP4-IgG+NMOSD). Serum neurofilament light chain (sNfL) is a biomarker for neuroaxonal damage. However, the association of sGFAP and sNfL with magnetic resonance imaging (MRI) volumes in AQP4-IgG+NMOSD is unclear. Objectives: To investigate the associations of sGFAP and sNfL with brain MRI volumes in AQP4-IgG+NMOSD. Design: Monocentric, retrospective, observational study. Methods: In 33 clinically stable patients with AQP4-IgG+NMOSD, 17 patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and 15 healthy controls (HC), sGFAP and sNfL were measured at 2 (HC = 1) and 3-Tesla MRIs were obtained at 4 (HC = 1) yearly visits. Associations between biomarkers and MRI metrics were evaluated using linear models. Results: In AQP4-IgG+NMOSD, but not in MOGAD and HC, higher sGFAP was associated with lower hippocampus (β = −2.0 (95% confidence interval: −3.4, −0.7), p  = 0.004) and thalamus volumes (β = −2.5 (−4.3, −0.7), p  = 0.006) and higher MRI cerebrospinal fluid volume (β = 1.8 (0.7, 3.2), p  = 0.01), and, statistically less robust, with lower whole brain (β = −2.3 (−5.3, 0.8), p  = 0.15) and gray matter volumes (β = −1.8 (−4.0, 0.4), p  = 0.10). Furthermore, higher sGFAP (β = −0.06 (−0.11, −0.002), p  = 0.04), but not sNfL (β = −0.02 (−0.08, 0.03), p  = 0.38), was associated with percent brain volume change in AQP4-IgG+NMOSD. Conclusion: The specific associations of sGFAP with brain MRI volumes corroborate sGFAP as a biomarker for disease activity in AQP4-IgG+NMOSD.https://doi.org/10.1177/17562864251345792
spellingShingle Patrick Schindler
Ulrike Grittner
Rebekka Rust
Susanna Asseyer
Judith Bellmann-Strobl
Tanja Schmitz-Hübsch
Michael Scheel
Sven Jarius
Brigitte Wildemann
Markus Reindl
Pascal Benkert
Jens Kuhle
Friedemann Paul
Klemens Ruprecht
Claudia Chien
Investigation of the association of serum GFAP and NfL with brain and upper cervical MRI volumes in AQP4-IgG-positive NMOSD and MOGAD
Therapeutic Advances in Neurological Disorders
title Investigation of the association of serum GFAP and NfL with brain and upper cervical MRI volumes in AQP4-IgG-positive NMOSD and MOGAD
title_full Investigation of the association of serum GFAP and NfL with brain and upper cervical MRI volumes in AQP4-IgG-positive NMOSD and MOGAD
title_fullStr Investigation of the association of serum GFAP and NfL with brain and upper cervical MRI volumes in AQP4-IgG-positive NMOSD and MOGAD
title_full_unstemmed Investigation of the association of serum GFAP and NfL with brain and upper cervical MRI volumes in AQP4-IgG-positive NMOSD and MOGAD
title_short Investigation of the association of serum GFAP and NfL with brain and upper cervical MRI volumes in AQP4-IgG-positive NMOSD and MOGAD
title_sort investigation of the association of serum gfap and nfl with brain and upper cervical mri volumes in aqp4 igg positive nmosd and mogad
url https://doi.org/10.1177/17562864251345792
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