Raised serum GFAP was linked to near-term MS progression without relapses

The edition in brief

In the Swiss MS Cohort and the US EPIC cohort, 2,329 people with multiple sclerosis had serum neurofilament light chain and glial fibrillary acidic protein (GFAP) measured repeatedly. GFAP above the 84th percentile was associated with about 40% higher hazard of progression independent of relapse activity (PIRA) over the next year (HR 1.45 and 1.36), whereas neurofilament light tracked relapses. Falling GFAP in the first two years of fingolimod or B-cell depletion was associated with lower later PIRA risk. A meta-analysis of 84 studies and 4.1 million people associated psychological stress (HR 1.27) and work stress (HR 1.32) with first-ever stroke. A review of 31 studies from South and Southeast Asia estimated dementia prevalence at about 3% overall, with Alzheimer prevalence in studies after 2010 around 8%, though heterogeneity was extreme. A meta-analysis of 29 trials of drugs for sleep problems in Parkinson disease found low-certainty improvement in overall sleep quality and insufficient evidence for daytime sleepiness, insomnia or REM sleep behaviour disorder. And the Dutch LIMS lifestyle programme for MS produced modest, mostly short-term gains in patient-reported impact, with lasting change in diet and weight but not in exercise.