{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:05:06Z","timestamp":1789621506932,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Autoimmune glial fibrillary acidic protein astrocytopathy (GFAP\u2010A) is an inflammatory central nervous system disorder with variable outcomes. Relapse occurs in a subset of patients, but early predictors remain unclear. We aimed to identify admission\u2010available features associated with 1\u2010year recurrence and develop an interpretable risk stratification model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively included 156 patients with CSF GFAP\u2010IgG\u2010positive GFAP\u2010A between January 2021 and February 2025. Patients were classified by recurrence within 1\u2009year. Early demographic, clinical, CSF, serological, neuroimaging, and treatment\u2010related variables were compared between groups. Candidate predictors were screened using elastic net regression with repeated cross\u2010validation, followed by multivariable logistic regression and internal validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010five patients (22.4%) relapsed within 1\u2009year. Patients with and without recurrence within 1\u2009year were broadly comparable in age, sex, baseline severity, neuroimaging findings, and treatment exposure. Patients with recurrence within 1\u2009year had lower CSF white blood cell counts (42.0 [10.0\u2013104.0] vs. 107.0 [34.0\u2013200.0]\u2009\u00d7\u200910\n                      <jats:sup>6<\/jats:sup>\n                      \/L;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and more frequent movement disorders (71.4% vs. 43.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). The final model included CSF white blood cell count, movement disorders, CSF chloride, and CSF GFAP\u2010IgG titer category. Lower CSF white blood cell count, movement disorders, and higher GFAP\u2010IgG titer category were associated with increased recurrence risk. The model showed acceptable optimism\u2010corrected discrimination (AUC, 0.726), reasonable calibration, and potential clinical utility. Machine\u2010learning models did not outperform logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>In GFAP\u2010A, 1\u2010year recurrence was associated with distinct early clinical and CSF features rather than baseline severity or treatment exposure alone. This admission\u2010based model may support recurrence risk stratification and follow\u2010up planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70535","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:49:51Z","timestamp":1789620591000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Clinical and Cerebrospinal Fluid Predictors of 1\u2010Year Recurrence in Autoimmune\n                    <scp>GFAP<\/scp>\n                    Astrocytopathy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3184-4203","authenticated-orcid":false,"given":"Qingting","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Neurology The Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong People's Republic of 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Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurology The Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2768-1654","authenticated-orcid":false,"given":"Yaqing","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Neurology The Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1339-9877","authenticated-orcid":false,"given":"Tingting","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology The Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology The Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0880-958X","authenticated-orcid":false,"given":"Wei","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Neurology The Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuge","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology The Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong People's Republic of 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