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Plasma glial fibrillary acidic protein detects Alzheimer pathology and predicts future conversion to Alzheimer dementia in patients with mild cognitive impairment
Cicognola C, Janelidze S, Hertze J, Zetterberg H, Blennow K, Mattsson-Carlgren N, Hansson O. Alzheimer's Research & Therapy, 2021-03-27
Topic: Amyloid, tau and blood-test diagnosis
A simple blood test for GFAP, a protein released by activated star-shaped brain support cells called astrocytes, could identify which patients with mild memory problems had underlying Alzheimer's pathology and predict, years in advance, who would go on to develop Alzheimer's dementia.
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APA 7th
Cicognola, C., Janelidze, S., Hertze, J., Zetterberg, H., Blennow, K., Mattsson-Carlgren, N., et al. (2021). Plasma glial fibrillary acidic protein detects Alzheimer pathology and predicts future conversion to Alzheimer dementia in patients with mild cognitive impairment. Alzheimer's Research & Therapy.
Vancouver
Cicognola C, Janelidze S, Hertze J, Zetterberg H, Blennow K, Mattsson-Carlgren N, et al. Plasma glial fibrillary acidic protein detects Alzheimer pathology and predicts future conversion to Alzheimer dementia in patients with mild cognitive impairment. Alzheimer's Research & Therapy. 2021. PMID: 33773595.
BibTeX
@article{cicognola2021-d7e9adeb,
author = {Cicognola, C. and Janelidze, S. and Hertze, J. and Zetterberg, H. and Blennow, K. and Mattsson-Carlgren, N. and Hansson, O.},
title = {{Plasma glial fibrillary acidic protein detects Alzheimer pathology and predicts future conversion to Alzheimer dementia in patients with mild cognitive impairment}},
journal = {Alzheimer's Research \& Therapy},
year = {2021},
pmid = {33773595}
}
Built from the record alzhub holds for this paper, not looked up. This record has no DOI, so the citation leaves it out. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- In 160 MCI patients, baseline plasma GFAP predicted abnormal amyloid status with AUC 0.79, improving to 0.86 when combined with APOE genotype
- GFAP predicted conversion to Alzheimer's dementia over an average 4.7-year follow-up with AUC 0.84
- GFAP levels rose faster over time in patients who were amyloid-positive than those who were amyloid-negative
- Findings support GFAP as a blood marker of astrocyte reactivity tied specifically to amyloid pathology, complementing p-tau and NfL
Why it matters
A blood test for GFAP identified which patients with mild cognitive impairment had underlying Alzheimer's pathology and predicted who later developed dementia. This points to GFAP as a possible blood marker for identifying patients for trials or monitoring, not as a treatment.
Study details
- Study designcohort
- Participants160
- Effect sizeBaseline plasma GFAP detected abnormal CSF Aβ42/40 with AUC 0.79 (95% CI 0.72-0.86); GFAP+APOE improved this to AUC 0.86; GFAP predicted conversion to Alzheimer's dementia with AUC 0.84 (95% CI 0.77-0.91)
- Evidence strengthModerate
Limitations
Single memory-clinic cohort (not population-based) with a moderate sample size (n=160); GFAP rises in other neurodegenerative and neuroinflammatory conditions too, so it is not Alzheimer's-specific on its own.
How this study scored 61/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded and indexed in PubMed because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 38 of the 62 points we could judge it on, which is 61 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer's Research & Therapy) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 2 / 4 | 160 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 0 / 2 | No PubMed ID and no DOI — scores zero (not stated in the record — scored 0) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 38 / 62 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 38 of the 62 points we could judge it on is 61 out of 100. |
| Total | 61 / 100 | — |
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