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  • Poor long-term outcomes and abnormal neurodegeneration biomarkers after military traumatic brain injury: the ADVANCE study

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Poor long-term outcomes and abnormal neurodegeneration biomarkers after military traumatic brain injury: the ADVANCE study
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  • Published on: 16 January 2025
    Addressing Long-Term Outcomes and Neurodegeneration Biomarkers After Military Traumatic Brain Injury
    • Ali Shokrollahi, MD Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

    Dear Editor,
    I am writing to express my thoughts on the thought-provoking article titled, "Poor long-term outcomes and abnormal neurodegeneration biomarkers after military traumatic brain injury: the ADVANCE study." This comprehensive study delves into the long-term impacts of traumatic brain injury (TBI) on UK military personnel, focusing on the prevalence, psychological consequences, functional impairments, and the role of fluid biomarkers in elucidating the ongoing neurodegenerative processes associated with these injuries.
    One of the critical aspects of this study is its detailed examination of plasma biomarkers, including neurofilament light (NfL) and glial fibrillar acidic protein (GFAP), which serve as indicators of axonal damage and astrocytic activation, respectively. The sustained elevation of GFAP levels, detected even 8 years post-injury, suggests a prolonged neuroinflammatory response and astrocytic reactivity that could contribute to chronic neurodegeneration. This aligns with existing literature on the role of GFAP in central nervous system injury, where it is often linked to the activation and proliferation of astrocytes as part of the neuroinflammatory response. The finding of a 47% higher concentration of GFAP in moderate-to-severe TBI cases compared to mild cases indicates a dose-response relationship that highlights the progressive nature of astroglial activation in severe injuries.
    It is particularly intriguing that while GF...

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    Conflict of Interest:
    None declared.