Glial Fibrillary Acidic Protein: Is There a Relationship with the Course of Multiple Sclerosis and Traumatic Brain Injury before the Onset of Multiple Sclerosis?

Objectives. To evaluate relationships between the blood glial fibrillary acidic protein (GFAP) level and the rate of progression of neurological disorders and the frequency of exacerbations of multiple sclerosis (MS) in the presence/absence of traumatic brain injury (TBI) before the onset of MS. Materials and methods. Caucasians born and living in the Altai District of Russia with relapsing-remitting MS in remission took part in a cross-sectional observational randomized study: 43 patients without any history of TBI and 43 with TBI before the onset of MS (at age 36.1 ± 9.3 and 33.5 ± 8.2 years, duration of MS 7.6 ± 6.6 and 5.9 ± 4.6 years respectively). Patients sustained TBI 14.8 ± 7.8 years before the onset of MS and was documented in 76% of patients as concussion. Results. Groups of patient did not differ in terms of the frequency of MS exacerbations, while the rate of progression was higher in the group with a history of TBI (p = 0.013). No between-group differences in GFAP levels were found and there were no significant correlations between GFAP levels and the rate of progression (p = 0.520 in the group with TBI; p = 0.255 in the group without TBI) or the frequency of MS exacerbations. No differences were found in the rate of progression or GFAP levels between subgroups of patients with different clinical forms of TBI (H = 0.26; p = 0.880 and H = 1.48; p = 0.476 respectively). No correlation was found between the duration of TBI and the rate of progression (p = 0.902) or the GFAP level (p = 0.413). Conclusion. The results obtained here suggest a low probability that there are any relationships between the blood GFAP level in MS patients during remission and either the possible late consequences of TBI sustained before onset of MS or the course of MS.