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Proteoform-resolved neoGFAP as a diagnostic and prognostic biomarker across the TBI--MCI--AD continuum in Veterans
Haskins, W. E.; Wang, K. K.; Cai, G.; Boukholda, K.; Elbayoumi, E.; Bajpai, R.; Jackson, D.; Tehas et al.. medRxiv (preprint), 2026-09-03
Topic: Brain proteins, microglia and lab models
Service members with traumatic brain injury are at approximately two- to four-fold higher risk of Alzheimers disease or related dementias than those without such an injury, with risk increasing with injury severity. In the whole benchmarking cohort, neoGFAP discriminated mild cognitive impairment plus Alzheimers disease from non-Alzheimer subjects with an area under the receiver-operating-characteristic curve of 0.81 versus 0.73 for total GFAP, a trend-level advantage that did not reach nominal significance. Within the gate-positive, amyloid-committed subset of 23 subjects, neoGFAP dominance became significant by McNemars exact test (six discordant subjects favoured neoGFAP, none the reverse). Across diagnostic contrasts, neoGFAP outperformed total GFAP for Alzheimers disease versus control and, importantly for Veterans, for mild cognitive impairment versus chronic blast-exposed Veterans without cognitive impairment. In a same-cohort ProQuantum replication (n=57), CSF neoGFAP preserved its discrimination advantage over total GFAP for MCI+AD versus non-AD (AUROC 0.76 vs 0.72; cross-platform Spearman {rho}=0.84), while plasma neoGFAP achieved AUROC 0.90, comparable to pTau217 (0.92) and exceeding A{beta}42/40 (0.84).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Haskins, W. E., Wang, K. K., Cai, G., Boukholda, K., Elbayoumi, E., Bajpai, R., et al. (2026). Proteoform-resolved neoGFAP as a diagnostic and prognostic biomarker across the TBI--MCI--AD continuum in Veterans. medRxiv (preprint). https://doi.org/10.64898/2026.09.01.26361845
Vancouver
Haskins WE, Wang KK, Cai G, Boukholda K, Elbayoumi E, Bajpai R, et al. Proteoform-resolved neoGFAP as a diagnostic and prognostic biomarker across the TBI--MCI--AD continuum in Veterans. medRxiv (preprint). 2026. doi:10.64898/2026.09.01.26361845.
BibTeX
@article{haskins2026-2ab27f16,
author = {Haskins, W. E. and Wang, K. K. and Cai, G. and Boukholda, K. and Elbayoumi, E. and Bajpai, R. and Jackson, D. and Tehas and others},
title = {{Proteoform-resolved neoGFAP as a diagnostic and prognostic biomarker across the TBI--MCI--AD continuum in Veterans}},
journal = {medRxiv (preprint)},
year = {2026},
doi = {10.64898/2026.09.01.26361845},
url = {https://doi.org/10.64898/2026.09.01.26361845}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Service members with traumatic brain injury are at approximately two- to four-fold higher risk of Alzheimers disease or related dementias than those without such an injury, with risk increasing with injury severity.
- In the whole benchmarking cohort, neoGFAP discriminated mild cognitive impairment plus Alzheimers disease from non-Alzheimer subjects with an area under the receiver-operating-characteristic curve of 0.81 versus 0.73 for total GFAP, a trend-level advantage that did not reach nominal significance.
- Within the gate-positive, amyloid-committed subset of 23 subjects, neoGFAP dominance became significant by McNemars exact test (six discordant subjects favoured neoGFAP, none the reverse).
- Across diagnostic contrasts, neoGFAP outperformed total GFAP for Alzheimers disease versus control and, importantly for Veterans, for mild cognitive impairment versus chronic blast-exposed Veterans without cognitive impairment.
- In a same-cohort ProQuantum replication (n=57), CSF neoGFAP preserved its discrimination advantage over total GFAP for MCI+AD versus non-AD (AUROC 0.76 vs 0.72; cross-platform Spearman {rho}=0.84), while plasma neoGFAP achieved AUROC 0.90, comparable to pTau217 (0.92) and exceeding A{beta}42/40 (0.8
Why it matters
This study found that a marker called neoGFAP showed a trend-level advantage over total GFAP for distinguishing mild cognitive impairment plus Alzheimer's from non-Alzheimer subjects, with a significant advantage only in a small subset of 23 subjects. It is a biomarker study and does not test any treatment, cure or prevention.
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Study details
- Participants57
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 33 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on impact for its field and year, so that was left out: it earned 31 of the 94 points we could judge it on, which is 33 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv (preprint)) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 57 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| 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 | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| 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 | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Elaine R. Peskind: h-index 112 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 10 institution(s) in 2 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 31 / 94 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 31 of the 94 points we could judge it on is 33 out of 100. |
| Total | 33 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
Read the original
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