Initial CSF total tau correlates with 1-year outcome in patients with traumatic brain injury
Abstract
OBJECTIVE: We investigated if tau, microtubular binding protein, in serum and ventricular CSF (vCSF) in patients with severe traumatic brain injury (TBI) during the initial posttraumatic days correlated to 1-year outcome. METHODS: Patients with severe TBI (n = 39, Glasgow Coma Scale score <or=8) were included. We measured serum and vCSF total tau on days 0 to 14, using ELISA. vCSF total tau correlated to 1-year Extended Glasgow Outcome Scale (GOSE), the NIH Stroke Scale (NIHSS) neurologic status, and the Bartel Daily Living Index. Patients (n = 20) with normal pressure hydrocephalus (NPH) served as reference. RESULTS: Higher levels of tau were found in TBI patients vs patients with NPH. A correlation was found between initial vCSF total tau and GOSE levels (R = 0.42, p < 0.001) but not between vCSF total tau and NIHSS or Bartel scores at 1 year. A vCSF total tau level of >2,126 pg/mL on days 2 to 3 discriminated between dead and alive (sensitivity of 100% and a specificity of 81%). A vCSF total tau level of >702 pg/mL on days 2 to 3 discriminated between bad (GOSE 1 to 4) and good (GOSE 5 to 8) outcome (sensitivity of 83% and a specificity of 69%). Patients with GOSE 1 (dead) had higher vCSF total tau levels on days 2 to 3 (p < 0.001) vs both surviving patients (GOSE 2 to 8) and those with NPH. Total tau was not detected in serum throughout the study. CONCLUSION: The increase in ventricular CSF (vCSF) total tau probably reflects axonal damage, known to be a central pathologic mechanism in traumatic brain injury (TBI). These results suggest that vCSF total tau may be an important early biochemical neuromarker for predicting long-term outcome in patients with a severe TBI.
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There is a marked temporary increase in T-tau, with no change in P-tau, in traumatic brain injury and stroke that correlates with the severity of neuronal damage.
“There is a marked temporary increase in T-tau, with no change in P-tau, in traumatic brain injury and stroke that correlates with the severity of neuronal damage [146,147].”
From NIA‐AA Research Framework: Toward a biological definition of Alzheimer's disease (2018) · cites this paper as [147]
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- Authors
- Öst, M., Nylén, K., Csajbok, L., Öhrfelt, A. O., Tullberg, M., Wikkelsö, C., Nellgård, P., Rosengren, L., Blennow, K., & Nellgård, B.
- Affiliations
- From the Departments of Anesthesiology and Intensive Care Medicine (M.Ö., L.C., P.N., B.N.), Neurology (K.N., L.R.), and Neurochemistry (A.O.O., K.B.) and Institute of Clinical Neuroscience (M.T., C.W.), Sahlgrenska University Hospital, Gothenburg, Sweden.
- Sahlgrenska University Hospital (SE)
- Venue
- Neurology
- Published
- 2006-11-14
- Volume
- 67
- Issue
- 9
- Pages
- 1600-1604
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2154813265
- Cited by
- 321
- References
- 0
- Citations by year
- 2026: 8 · 2025: 18 · 2024: 18 · 2023: 16 · 2022: 10 · 2021: 16 · 2020: 28 · 2019: 19 · 2018: 15 · 2017: 28 · 2016: 21 · 2015: 16 · 2014: 20 · 2013: 24 · 2012: 16
- FWCI
- 6.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- traumatic brain injury, cerebrospinal fluid tau, total tau, ventricular CSF, axonal injury, neurodegeneration biomarkers, long-term outcome prediction, Glasgow Outcome Scale-Extended, normal pressure hydrocephalus, mortality prediction, prognostic factors
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Axons, Brain, Brain Injuries, Cerebrospinal Fluid Proteins, Female, Humans, Male, Microtubules, Middle Aged, Predictive Value of Tests, Prognosis, Time, Wallerian Degeneration, tau Proteins, Disease Progression, Lateral Ventricles, Diffuse Axonal Injury
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