Researchers at UT Southwestern Medical Center have found that a molecule called glial fibrillary acidic protein (GFAP) rises significantly in the blood after patients undergo high-intensity focused ultrasound (HIFU)—a treatment for tremors that causes controlled brain damage similar to a small stroke.
Their findings, published in Brain Communications, suggest that GFAP could serve as a biomarker for stroke and brain injuries, potentially leading to faster and more accurate diagnoses through blood tests.
The Search for a Reliable Brain Injury Marker
Each year, nearly 800,000 people in the U.S. experience a stroke, which occurs when blood flow to part of the brain is blocked. Strokes can cause permanent brain damage or death if not treated quickly.
While MRI scans are currently the main method for diagnosing strokes, they can be slow and are not always available in emergencies. A blood test that detects brain injury could help doctors identify strokes faster, leading to quicker treatment and better outcomes.
Why HIFU Was Used as a Research Model
HIFU is a treatment approved by the FDA in 2016 for tremor disorders, such as Parkinson’s disease and essential tremor. It works by burning a small targeted area in the brain, specifically in the thalamus, where tremors originate. Researchers realized that the type of controlled damage caused by HIFU is very similar to stroke when viewed on brain scans.
This similarity made HIFU an ideal model for studying brain injury biomarkers in a controlled way. Unlike stroke, which happens suddenly and unpredictably, HIFU allows researchers to measure blood markers before and after the injury at precise time points.
Study Findings: GFAP Shows the Biggest Increase
The research team studied 30 patients with tremor-dominant Parkinson’s disease or essential tremor who underwent HIFU. Blood samples were taken before treatment, one hour after, and 48 hours after. They measured five different molecules previously linked to brain injuries:
- GFAP
- Neurofilament light chain (NfL)
- Amyloid-beta 40
- Amyloid-beta 42
- Phosphorylated tau 181 (pTau-181)
After 48 hours, four of these markers showed a significant increase, but GFAP levels rose the most, increasing more than four times their original level on average.
What This Means for Stroke Diagnosis
The dramatic rise in GFAP suggests it could be a strong candidate for a stroke biomarker. If a blood test could quickly measure GFAP levels, doctors might be able to detect brain injury earlier and more accurately, potentially improving emergency stroke treatment.
The researchers are now conducting further studies to understand how GFAP levels change over time and whether it rises in actual stroke patients. They are also exploring hundreds of other molecules to find even earlier indicators of brain injury.
Future Implications
If validated, a GFAP-based blood test could help doctors rapidly diagnose strokes, concussions, and other brain injuries. It might also be useful in monitoring brain health in patients with neurodegenerative diseases like Alzheimer’s or Parkinson’s.
“This study shows that focused ultrasound can be used as a powerful tool for discovering biomarkers for brain diseases,” said Dr. Nil Saez-Calveras, one of the study’s co-leaders.
With continued research, this discovery could revolutionize stroke diagnosis and treatment, making brain injuries easier to detect and manage in the future.
The research findings can be found in Brain Communications.
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