Objective: To investigate whether baseline cerebrospinal fluid (CSF) glial fibrillary acidic protein (GFAP) levels predict changes in cognitive performance (MOCA) and motor severity (UPDRS) over a two-year follow-up period in patients with Parkinson’s disease (PD).
Background: Astroglial activation and neuroinflammation are key contributors to PD pathophysiology. GFAP, a marker of astroglial activation, may be elevated early in PD, suggesting astrocytic dysfunction and inflammation could influence disease progression.
Method: We conducted an observational analysis using data from the Parkinson’s Progression Markers Initiative (PPMI), selecting idiopathic PD patients with available baseline GFAP levels and two-year follow up data. For all participants, demographic variables (age, sex), disease duration, motor severity (MDS-UPDRS III), and cognitive status (MoCA) were analyzed. A multiple linear regression analysis was performed to investigate whether baseline CSF GFAP levels predicted longitudinal changes in cognitive and motor outcomes over a two-year period in patients with PD. ΔMoCA and ΔUPDRS III (two-year follow-up vs. baseline) served as dependent variables, with their respective baseline scores included as covariates to account for regression to the mean. Age, sex, and disease duration were included as covariates to control for potential confounding effects.
Results: A total of 72 patients with Parkinson’s disease were included in the regression analysis. Baseline GFAP levels were not significantly associated with longitudinal cognitive change measured by ΔMOCA after adjusting for age, sex, and disease duration (β = 0.07, p = 0.669). Among the covariates, age showed a significant association with ΔMOCA (β = 0.09, p = 0.029), indicating that older age was associated with greater decline in MOCA scores. Similarly, baseline GFAP was not significantly associated with motor progressionmeasured by ΔUPDRS III (β = 0.16, p = 0.753) after adjusting for covariates.
Conclusion: CSF GFAP alone shows limited short-term prognostic value in PD, reflecting inconsistencies in prior literature. Integrating GFAP with other neurodegenerative and inflammatory biomarkers could yield a more robust prognostic framework.
To cite this abstract in AMA style:
Z. Huseynli. Longitudinal Association Between Baseline CSF GFAP Levels and Clinical Progression in Parkinson’s Disease A PPMI Study [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/longitudinal-association-between-baseline-csf-gfap-levels-and-clinical-progression-in-parkinsons-disease-a-ppmi-study/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-association-between-baseline-csf-gfap-levels-and-clinical-progression-in-parkinsons-disease-a-ppmi-study/