Serum GFAP and NfL levels in migraine: A registry for migraine (REFORM) study

ObjectiveTo determine whether serum glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) concentrations differ between adults with migraine and healthy controls.MethodsThis single-center, cross-sectional study was conducted from September 2020 to June 2022. Adults diagnosed with migraine and healthy controls were enrolled. Serum GFAP and NfL concentrations were quantified using an ultra-sensitive single-molecule array platform. Analyses were adjusted for potential confounders, including age, sex, body mass index and smoking status.ResultsWe assessed serum samples from 603 participants with migraine and 154 controls. Serum GFAP concentrations were 6.8% higher in the overall migraine group compared to controls (95% confidence interval = 0.4-13.5%; <i>P</i> = 0.036). Conversely, serum NfL concentrations did not differ between participants with migraine and controls (difference: -1.4%; 95% confidence interval = -7.9 to 5.6%; <i>p</i> = 0.68). Neither serum GFAP, nor NfL concentrations varied according to migraine subtype or headache status at the time of blood sampling.ConclusionsOur findings demonstrate a modest yet statistically significant increase in serum GFAP among adults with migraine, independent of migraine subtype, whereas serum NfL levels were comparable to those of controls. Further research is needed to clarify the neurobiological mechanisms underlying elevated serum GFAP in migraine.