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Glial fibrillary acidic protein: a blood biomarker to differentiate neurodegenerative from psychiatric diseases
  1. Henrik Zetterberg
  1. Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Goteborg S-431 80, Sweden
  1. Correspondence to Dr Henrik Zetterberg, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Goteborg S-431 80, Sweden; henrik.zetterberg{at}

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Blood glial fibrillary acidic protein (GFAP) concentration is higher in frontotemporal lobar degeneration (FTLD) than in primary psychiatric disorders (PPD) and predicts disease progression in FTLD

Early symptoms of neurodegenerative and psychiatric diseases may be indistinguishable. It has become increasingly clear that the pathological changes underlying neurodegenerative diseases are well established before clinical presentation. These pathological changes, previously only observable at autopsy, can now be detected using biomarkers (imaging based or fluid based).1

To facilitate biomarker-based detection of neurodegeneration in clinical practice, easy-to-use blood tests for first-line testing would be of great value. Such tests have been developed for Alzheimer’s disease pathology (plasma Aβ42/Aβ40 ratio and phosphorylated tau species), and for neurofilament light (NfL), a more general biomarker for neuroaxonal injury in both acute and chronic neurological conditions has been developed.1 In contrast, it has been difficult to identify biomarkers for psychiatric diseases—none exists to date and the most general biomarker NfL is negative.

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  • Contributors The author solely wrote the manuscript.

  • Funding The author is a Wallenberg Scholar supported by grants from the Swedish Research Council (#2018-02532), the European Research Council (#681712), Swedish State Support for Clinical Research (#ALFGBG-720931), the Alzheimer Drug Discovery Foundation, USA (#201809-2016862), the AD Strategic Fund and the Alzheimer's Association (#ADSF-21-831376-C, #ADSF-21-831381-C and #ADSF-21-831377-C), the Olav Thon Foundation, the Erling-Persson Family Foundation, Stiftelsen för Gamla Tjänarinnor, Hjärnfonden, Sweden (#FO2019-0228), the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement no. 860197 (MIRIADE), and the UK Dementia Research Institute at UCL.

  • Competing interests The author has served at scientific advisory boards and/or as a consultant for Alector, Eisai, Denali, Roche Diagnostics, Wave, Samumed, Siemens Healthineers, Pinteon Therapeutics, Nervgen, AZTherapies, CogRx and Red Abbey Labs, has given lectures in symposia sponsored by Cellectricon, Fujirebio, Alzecure and Biogen and is a co-founder of Brain Biomarker Solutions in Gothenburg AB, which is a part of the GU Ventures Incubator Program (outside submitted work).

  • Provenance and peer review Commissioned; internally peer reviewed.

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