ArticleJAMA neurology2025
Blood-Based Biomarkers for Identifying Disease Activity in AQP4-IgG-Positive Neuromyelitis Optica Spectrum Disorder.
Article in JAMA neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Review
- Recognition and management of acute relapse of multiple sclerosis, neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease.Cell death and differentiation · 2026Review
- Use of Fluid Biomarkers in NMOSD and MOGAD: Clinical and Research Applications.Neurology(R) neuroimmunology & neuroinflammation · 2026Review
- Evaluation of Dried Plasma Spot-Based Quantification of Glial Fibrillary Acidic Protein as a Disease-Associated Biomarker in Neuromyelitis Optica Spectrum Disorder.Annals of clinical and translational neurology · 2026Article
- Article
- Intrathecal immunoglobulin production in the diagnosis, prognosis, and monitoring of autoimmune diseases of the central nervous system.Journal of translational autoimmunity · 2026Review
- Complement Inhibition for Acute Neuromyelitis Optica Spectrum Disorder Attacks: Insights From an International Case Series.Neurology(R) neuroimmunology & neuroinflammation · 2026Article
- Novel B-Cell targeting therapy with subcutaneous ofatumumab in AQP4-IgG-seronegative Neuromyelitis Optica Spectrum Disorders: efficacy and personalized dosing.Frontiers in immunology · 2026Article
- Neuroglial markers of damage in autoimmune neurology.Therapeutic advances in neurological disorders · 2026Review
- Double-seronegative neuromyelitis optica: it is not possible to interrupt treatment after 10 years of stability.Arquivos de neuro-psiquiatria · 2025Review
- Serum Autoantibody Titers and Neurofilament Light Chain Levels in CASPR2/LGI1 Encephalitis: A Longitudinal Study.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- Serum GFAP and NFL as biomarkers for disease activity, severity and disability in NMOSD.Journal of neurology · 2025Article
- Diagnosis of neuromyelitis optica with bilateral vision loss as initial symptom secondary to acute middle encephalitis: a report of three cases.American journal of translational research · 2025Article
- Eculizumab for the acute attack of neuromyelitis optica spectrum disorder.Frontiers in immunology · 2025Article
- Serum Lipid Biomarkers for the Diagnosis and Monitoring of Neuromyelitis Optica Spectrum Disorder: Towards Improved Clinical Management.Journal of inflammation research · 2025Article
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: The temporal dynamics of serum glial fibrillary acidic protein (sGFAP) and serum neurofilament light chain (sNfL) as biomarkers of disease activity for neuromyelitis optica spectrum disorder (NMOSD) remain underexplored. Objective: To determine optimal timing for assessing sGFAP and sNfL, establish cutoff values differentiating between attacks and remissions in NMOSD, and evaluate these findings across independent cohorts. Design, Setting, and Participants: This retrospective, longitudinal, multicenter cohort study was conducted among patients with aquaporin-4 antibody (AQP4-IgG)-positive NMOSD. Patients with available stored serum samples were included, totaling 181 patients with 625 samples. Discovery cohort samples were collected from February 2008 to October 2023 and validation cohort samples were collected from January 2013 to October 2023. A combined analysis of both cohorts was conducted from November 2023 to March 2024. Exposures: sNfL and sGFAP concentrations, measured by a single-molecule array assay. Main Outcomes and Measures: The primary outcomes were the optimal timing of assessing sGFAP and sNfL and the adjusted cutoff values for evaluating disease activity in NMOSD. Results: The discovery cohort consisted of 366 samples from 78 Korean patients (median [IQR] age, 35 [30-42] years; 73 female patients [95%]), while the validation cohort included 190 samples from 34 German patients (median [IQR] age, 54 [39-61] years; 32 female patients [94%]) and 69 samples from 69 Brazilian patients (median [IQR] age, 46 [35-55] years; 62 female patients [90%]). Six-month postattack temporal biomarker dynamics were analyzed in 202 samples from 74 patients in the discovery cohort: sGFAP levels peaked within the first week and sNfL levels peaked at 5 weeks postattack. The optimal time frames for evaluating attacks were within 1 week for sGFAP and from 1 to 8 weeks for sNfL, with remission defined as at least 6 months postattack. z Score cutoffs of 3.0 for sGFAP and 2.1 for sNfL effectively distinguished between attack and remission phases, indicated by area under the curve values of 0.95 (95% CI, 0.88-1.02) and 0.87 (95% CI, 0.82-0.91), respectively. The discovery cohort time frames and cutoff values were applied to the validation cohort, achieving 71% sensitivity and 94% specificity for sNfL and 100% sensitivity and specificity for sGFAP in the German and Brazilian cohorts. Conclusions and Relevance: This longitudinal cohort study established optimal timing and thresholds for sGFAP and sNfL, which were consistent in independent cohorts, supporting these biomarkers' effectiveness in distinguishing NMOSD attacks from remission.
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