Glial fibrillary acidic protein: is there a relationship with the course of multiple sclerosis and traumatic brain injury before the onset of multiple sclerosis?

Abstract

To evaluate the relationship between the level of glial fibrillary acidic protein (GFAP) in the blood and the rate of progression (RP) of neurological disorders and exacerbation frequency of multiple sclerosis (MS) in the presence/absence of traumatic brain injury (TBI) before the onset of MS. Caucasians born and living in the Altai region of Russia with relapsing-remitting MS in remission took part in a cross-sectional observational randomized study: 43 patients without a history of TBI and 43 patients with TBI before the onset of MS (mean age 36.1±9.3 and 33.5±8.2 years, MS duration 7.6±6.6 and 5.9±4.6 years, respectively). Intracranial injury occurred 14.8±7.8 years before the onset of MS and was documented as a concussion in 76% of patients. The patient groups did not differ in the frequency of MS exacerbations, while RP was higher in the group with a history of TBI (p=0.013). There were no intergroup differences in GFAP levels, as well as no correlations between GFAP levels and RP (p=0.520 and p=0.255 in groups with/without TBI, respectively) and the exacerbation frequency. No differences were found between subgroups of patients with different clinical forms of TBI in RP and GFAP levels (H=0.26; p=0.880 and H=1.48; p=0.476, respectively). There was no correlation of the TBI duration with RP (p=0.902) and GFAP level (p=0.413). The results indicate a low probability of a connection between the level of GFAP in the blood of patients with MS during the period of remission, both with the possible long-term consequences of a TBI occurred before the onset of MS, and during the course of MS.