Glial Fibrillary Acidic Protein and Neurofilament Light Reference Intervals in Healthy Individuals
By
Rebecca Z. Rousset
Madison I. J. Honey
Anouk den Braber
Wiesje M. van der Flier
Henne Holstege
Linda Lorenz
Mark H. J. Wessels
Joep Killestein
Martijn Huisman
Almar Kok
Marian Beekman
P. Eline Slagboom
Lannie Ligthart
Eco de Geus
Inge M. W. Verberk
Lisa Vermunt
Charlotte E. Teunissen
May 14, 2026
Clinical Scorecard: Reference Ranges for Glial Fibrillary Acidic Protein and Neurofilament Light Chain in Healthy Subjects
At a Glance
Category Detail
Condition Neurodegenerative diseases and neurological injuries Key Mechanisms GFAP as a biomarker of astrocyte injury; NfL as a biomarker of axonal injury Target Population Cognitively unimpaired adults aged 30 to 90 years Care Setting Clinical and research settings for neurological assessments
Key Highlights
GFAP and NfL concentrations are elevated in neurodegenerative diseases and after neurotrauma. Age, sex, kidney function, and BMI are biological modifiers affecting GFAP and NfL levels. Reference intervals for GFAP and NfL were established and validated using external datasets. Guideline-Based Recommendations
Diagnosis
Use GFAP and NfL concentrations to assess astrocyte and axonal injury in clinical settings. Management
Consider biological modifiers when interpreting GFAP and NfL levels. Monitoring & Follow-up
Regularly monitor GFAP and NfL levels in patients with neurological conditions. Risks
Be aware of the influence of age, sex, BMI, and kidney function on biomarker concentrations. Patient & Prescribing Data
Cognitively unimpaired individuals from Dutch cohorts
Reference intervals can guide clinical interpretation of GFAP and NfL in patients.
Clinical Best Practices
Utilize established reference intervals for GFAP and NfL in clinical assessments. Incorporate patient-specific factors such as age and BMI into biomarker interpretation. Related Resources & Content
