ArticleBrain communications2025
Plasma glial fibrillary acidic protein as a biomarker of acute focal brain injury after high-intensity focused ultrasound thalamotomy.
Article in Brain communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The validation of brain injury biomarkers has encountered challenges such as the absence of pre-insult measurements, variability in injury timing and location, and inter-individual differences. In this study, we addressed these limitations by using magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) thalamotomy to assess plasma biomarker changes after an acute focal brain injury. This prospective study included 30 essential tremor and tremor-dominant Parkinson's disease patients undergoing MRgHIFU thalamotomy at a single academic institution. Blood samples were collected at three specific time points: pre-procedure, 1-h post-procedure, and 48 h post-procedure. Plasma levels of glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), amyloid beta (Aβ40 and Aβ42) and phosphorylated tau 181 (pTau-181) were measured using the quanterix single molecule arrays assay. GFAP levels were significantly increased at 48 h post-MRgHIFU in all patients with a thalamotomy lesion. GFAP levels at 48 h were highly sensitive (89.7%) and specific (96.6%) in detecting the presence of a lesion with a cut-off value of 216.2 pg/ml. NfL, Aβ40 and Aβ42, also showed statistically significant increases post-procedure but were less robust than GFAP. No changes were observed in pTau-181 levels post-MRgHIFU. Plasma GFAP has shown great promise as a sensitive and reliable biomarker for detecting acute brain injury after MRgHIFU thalamotomy. Its significant elevation following the procedure highlights its potential as a diagnostic tool for acute focal brain injuries, such as stroke. Further studies with additional time points are essential to validate the injury cut-off identified in this study and to assess its broader clinical utility for early detection of focal brain lesions.
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