Serum glial fibrillary acidic protein as a marker of brain MRI metrics in multiple sclerosis: A scoping review.

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Magnetic resonance imaging (MRI) is heavily relied upon for the diagnosis and monitoring of multiple sclerosis (MS), a chronic, demyelinating disease of the central nervous system. Serum biomarkers may serve as an accessible tool for increasing sensitivity, improving accessibility, corroborating symptoms, and providing additional data to guide clinical management. This scoping review investigates the current understanding of how the serum biomarker glial fibrillary acidic protein (sGFAP) relates to brain MRI metrics. We adhered to the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The databases Medline (Ovid), Embase (Ovid), CINAHL (Ebsco), and Web of Science (University of British Columbia institutional access) were searched on August 24, 2023 using a combination of medical subject headings and keyword terms for the topic of serum biomarkers in MS. A total of 9880 articles were retrieved in total of which 6271 unique titles and abstracts were screened. Twelve of the 259 resultant papers contained sGFAP data and proceeded to extraction. It was found that lesion MRI metrics generally had a positive relationship with sGFAP, while gray matter and white matter metrics, including normal-appearing white matter, were related negatively or not at all. These results highlight that while sGFAP may not be specific for MS, it may have utility for increasing sensitivity in postdiagnosis monitoring of MS progression.