Serum Glial Fibrillary Acidic Protein (GFAP) Is a Marker of Disease Severity in Frontotemporal Lobar Degeneration

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, Barbara Borroni

Research output: Contribution to journalArticlepeer-review


Background: It is still unknown if serum glial fibrillary acidic protein (GFAP) is a useful marker in frontotemporal lobar degeneration (FTLD). Objective: To assess the diagnostic and prognostic value of serum GFAP in a large cohort of patients with FTLD. Methods: In 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. Results: We 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. Conclusion: Serum GFAP is increased in FTLD, correlates with cognition and GABAergic deficits, and thus shows promise as a biomarker of disease severity in FTLD.

Original languageEnglish
Pages (from-to)1129-1141
Number of pages13
JournalJournal of Alzheimer's Disease
Issue number3
Publication statusPublished - 2020


  • Biomarker
  • frontotemporal dementia
  • glial fibrillary acidic protein
  • magnetic resonance imaging
  • serum
  • survival
  • transcranial magnetic stimulation

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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