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Glial fibrillary acidic protein (GFAP) is an inflammatory marker derived from astrocytes. Research has demonstrated the potential of plasma GFAP to forecast the progression to dementia in PD patients with mild cognitive impairment (PD\u2013MCI). However, the predictive role of cerebrospinal fluid (CSF) GFAP on future cognitive transformation and alterations in Alzheimer\u2019s disease (AD)-associated CSF biomarkers in newly diagnosed PD patients has not been investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>210 de novo PD patients from the Parkinson\u2019s Progression Markers Initiative were recruited. Cognitive progression in PD participants was evaluated using Cox regression. Cross-sectional and longitudinal associations between baseline CSF GFAP and cognitive function and AD-related CSF biomarkers were evaluated using multiple linear regression and generalized linear mixed model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, the mean age of PD participants was 60.85\u2009\u00b1\u20099.78\u00a0years, including 142 patients with normal cognition (PD\u2013NC) and 68 PD\u2013MCI patients. The average follow-up time was 6.42\u2009\u00b1\u20091.69\u00a0years. A positive correlation was observed between baseline CSF GFAP and age (\u03b2\u2009=\u20090.918,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). There was no statistically significant difference in baseline CSF GFAP levels between PD\u2013NC and PD\u2013MCI groups. Higher baseline CSF GFAP predicted greater global cognitive decline over time in early PD patients (Montreal Cognitive Assessment, \u03b2\u2009=\u2009\u2212\u00a00.013,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). Furthermore, Cox regression showed that high baseline CSF GFAP levels were associated with a high risk of developing dementia over an 8-year period in the PD\u2013NC group (adjusted HR\u2009=\u20093.070, 95% CI 1.119\u20138.418,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029). In addition, the baseline CSF GFAP was positively correlated with the longitudinal changes of not only CSF \u03b1-synuclein (\u03b2\u2009=\u20090.313,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), but also CSF biomarkers associated with AD, namely, amyloid-\u03b2 42 (\u03b2\u2009=\u20090.147,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034), total tau (\u03b2\u2009=\u20090.337,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and phosphorylated tau (\u03b2\u2009=\u20090.408,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CSF GFAP may be a valuable prognostic tool that can predict the severity and progression of cognitive deterioration, accompanied with longitudinal changes in AD-associated pathological markers in early PD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12974-023-02843-5","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T07:03:35Z","timestamp":1689836615000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Cerebrospinal fluid GFAP is a predictive biomarker for conversion to dementia and Alzheimer\u2019s disease-associated biomarkers alterations among de novo Parkinson\u2019s disease patients: a prospective cohort study"],"prefix":"10.1186","volume":"20","author":[{"given":"Tingting","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongzhou","family":"Zuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oumei","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"issue":"10291","key":"2843_CR1","doi-asserted-by":"publisher","first-page":"2284","DOI":"10.1016\/S0140-6736(21)00218-X","volume":"397","author":"BR Bloem","year":"2021","unstructured":"Bloem BR, Okun MS, Klein C. 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