June 1, 2025Alzheimer s & Dementia9 citationsOpen Access

Plasma NfL and GFAP for predicting VCI and related brain changes in community and clinical cohorts

SRSheelakumari RaghavanMayo Clinic JGJonathan Graff‐RadfordMayo Clinic EHEkaterina I. HofrenningMayo Clinic in Florida

Structured PICO

Do plasma NfL and GFAP predict vascular cognitive impairment and related brain changes in community and clinical cohorts?

Population

Community and clinical cohorts including participants with vascular cognitive impairment (VCI), vascular cognitively unimpaired (CU), non-vascular cognitive impairment (CI), and non-vascular CU.

Intervention

Measurement of plasma NfL (neurofilament light chain) and GFAP (glial fibrillary acidic protein)

Comparator

Comparison across diagnostic states (VCI, vascular CU, non-vascular CI, non-vascular CU)

Outcome

Vascular brain indices and discrimination of vascular from non-vascular statessurrogate

Plasma NfL and GFAP are associated with vascular brain indices and can help discriminate vascular from non-vascular cognitive impairment states, particularly in amyloid-negative individuals.

Abstract

Plasma NfL and glial fibrillary acidic protein (GFAP) were associated with vascular brain indices. Plasma biomarkers differed across diagnostic states (VCI > vascular CU > non-vascular CI > non-vascular CU). Plasma markers discriminated vascular from non-vascular states with greater separation in Aβ- participants. NfL was linked to vascular health, while amyloid influenced GFAP variability in the population-based sample. Future longitudinal frameworks should consider systemic inflammation markers along with these plasma markers to better understand VCID-related brain changes and cognitive decline.

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