Serum Glial Fibrillary Acidic Protein (GFAP) as a Potential Biomarker for Monitoring Postoperative Complications in Deep Brain Stimulation Surgery

Deep brain stimulation (DBS) is an efficient treatment for movement disorders, most commonly Parkinson’s Disease (PD), dystonia and essential tremor. DBS surgery carries risks, e.g. the risk of delayed peri-lead edema (PLE) and the risk of postoperative cognitive decline. The mechanisms of these complications are not fully understood and there is no established biomarker to screen for these complications after DBS surgery. To assess whether serum glial fibrillary acid protein (sGFAP) might constitute a potentially useful biomarker to detect complications after DBS surgery, we measured sGFAP and serum neurofilament light chain (sNfl) in 58 patients undergoing DBS at our center. Both serum markers increased transiently after surgery. Serum GFAP returned to baseline after weeks, whereas sNfl only returned to baseline after months. Patients with poorer preoperative cognitive performance had higher postoperative sGFAP values, and the relationship of sGFAP with preoperative patient characteristics was closer than for sNfl. These properties suggest that sGFAP can be a valuable biomarker to monitor patients for delayed complications after DBS surgery.