ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1546270
High serum glial fibrillary acidic protein levels are associated with increased risk of post-stroke cognitive impairment Authors and Affiliations
Provisionally accepted
- Suzhou Ninth People's Hospital, Suzhou, China
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The correlation between glial fibrillary acidic protein (GFAP) and cognitive impairment in acute ischemic stroke patients remains uncertain.We aimed to evaluate GFAP in serum as predictor of post-stroke cognitive impairment (PSCI) at 90 days. Methods: From March 2022 to February 2023, patients with firstever ischemic stroke were prospectively enrolled. Serum GFAP concentrations were measured within 24 h after admission using an enzyme-linked immunosorbent assay.Cognitive function measurement was performed at the 90 days follow-up using the Mini-mental State Examination (MMSE). A MMSE score <27 was defined as PSCI.Multiple logistic regression and restricted cubic spline were performed to examine the association between GFAP and cognitive impairment. Results: A total of 336 patients (mean age: 66.3 ± 9.0 years; 58.3% male) with acute ischemic stroke were included.The median GFAP levels were 0.73 ng/mL (interquartile range, 0.38-1.09 ng/mL).During the 3-month follow-up, 164 participants (48.8%) experienced PSCI. Higher GFAP levels were independently associated with PSCI after adjusting for potential confounders (per 1-unit increase, odds ratio: 3.91; 95% confidence interval: 2.24-6.82; P=0.001). Additionally, restricted cubic spline confirmed a linear relationship between serum GFAP concentrations and PSCI risk (P for linearity = 0.001).Conclusions: This study demonstrated that higher levels of GFAP were associated with PSCI, suggesting that GFAP could be a promising and straightforward screening indicator of cognitive impairment after stroke.
Keywords: Acute ischemic stroke, cognitive impairment, GFAP, biomarker, prediction
Received: 16 Dec 2024; Accepted: 29 Apr 2025.
Copyright: © 2025 Shan, Jiang, Wang, Zhao, Zhai and Shao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiaxin Shao, Suzhou Ninth People's Hospital, Suzhou, China
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