Admission Levels of Total Tau and β-Amyloid Isoforms 1–40 and 1–42 in Predicting the Outcome of Mild Traumatic Brain Injury

Abstract

Background: The purpose of this study was to investigate if admission levels of total tau (T-tau) and β-amyloid isoforms 1-40 (Aβ40) and 1-42 (Aβ42) could predict clinical outcome in patients with mild traumatic brain injury (mTBI). Methods: A total of 105 patients with mTBI [Glasgow Coma Scale (GCS) ≥ 13] recruited in Turku University Hospital, Turku, Finland were included in this study. Blood samples were drawn within 24 h of admission for analysis of plasma T-tau, Aβ40, and Aβ42. Patients were divided into computed tomography (CT)-positive and CT-negative groups. The outcome was assessed 6-12 months after the injury using the Extended Glasgow Outcome Scale (GOSE). Outcomes were defined as complete (GOSE 8) or incomplete (GOSE < 8) recovery. The Rivermead Post Concussion Symptoms Questionnaire (RPCSQ) was also used to assess mTBI-related symptoms. Predictive values of the biomarkers were analyzed independently, in panels and together with clinical parameters. Results: The admission levels of plasma T-tau, Aβ40, and Aβ42 were not significantly different between patients with complete and incomplete recovery. The levels of T-tau, Aβ40, and Aβ42 could poorly predict complete recovery, with areas under the receiver operating characteristic curve 0.56, 0.52, and 0.54, respectively. For the whole cohort, there was a significant negative correlation between the levels of T-tau and ordinal GOSE Hossain et al. T-Tau, Aβ40 and Aβ42 in mTBI score (Spearman ρ = −0.231, p = 0.018). In a multivariate logistic regression model including age, GCS, duration of posttraumatic amnesia, Injury Severity Score (ISS), time from injury to sampling, and CT findings, none of the biomarkers could predict complete recovery independently or together with the other two biomarkers. Plasma levels of T-tau, Aβ40, and Aβ42 did not significantly differ between the outcome groups either within the CT-positive or CT-negative subgroups. Levels of Aβ40 and Aβ42 did not significantly correlate with outcome, but in the CT-positive subgroup, the levels of T-tau significantly correlated with ordinal GOSE score (Spearman ρ = −0.288, p = 0.035). The levels of T-tau, Aβ40, and Aβ42 were not correlated with the RPCSQ scores. Conclusions: The early levels of T-tau are correlated with the outcome in patients with mTBI, but none of the biomarkers either alone or in any combinations could predict complete recovery in patients with mTBI.

The Medicolegal aspects of road traffic accidents (RTAs) and evidence of Tau protein as a prognostic factor

“…On the other hand, Thelin et al, (2019) demonstrated that tau protein provided a highly significant predictor of outcome and mortality following TBI. Also, Hossain et al, (2020) revealed that the results of patients with mild TBI were substantially connected with the amounts of tau protein present at the time of admission. Therefore, tau protein may be able to predict the sequelae of mild TBI.…”

Blood‐based biomarkers and traumatic brain injury—A clinical perspective

“…43 In patients with mTBI, it has been observed that though T-tau levels are correlated with outcome, they are not able to predict full recovery. 42 Biomarker panels have also shown promise in outcome prediction as shown earlier in case of combining GFAP and UCH-L1. 64 In a study including multiple biomarkers, a combination of GFAP, heart fatty acid binding protein (H-FABP) and NF-L yielded a specificity of 40% when sensitivity was set at 95%-100% in predicting complete recovery in patients with mild TBI.…”

“…The P‐tau levels and P‐tau/T‐tau ratio outperformed the T‐tau level in discriminating patients with favourable and unfavourable outcome in patients with moderate to severe TBI 43 . In patients with mTBI, it has been observed that though T‐tau levels are correlated with outcome, they are not able to predict full recovery 42 …”

“…40 Most tau biomarker research in neurotrauma has focused on total tau (T-tau). 42 TBI results in both hyperphosphorylation and cleavage of tau proteins. Therefore, research interest has also focused on both cleaved tau (c-tau) and phosphorylated tau (p-tau).…”

Nanoporous Carbon Immunosensor for Highly Accurate and Sensitive Clinical Detection of Glial Fibrillary Acidic Protein in Traumatic Brain Injury, Stroke, and Spinal Cord Injury

“…Several proteins, such as glial fibrillary acidic protein (GFAP), S100 astroglial calcium-binding protein B (S100B), cleaved-tau protein, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and neurofilament light polypeptide, , have been identified as potential fluid biomarkers of CNS injuries . While clinical assessments and imaging techniques are used to diagnose many CNS injuries, the detection of these fluid biomarkers may provide an equally accurate and objective assessment, complementing currently used clinical assessments. ,,, In recent years, astrocytes have become a major focus of CNS injuries due to their pivotal roles in the neurovascular unit, including blood–brain barrier (BBB) function, cerebrovascular regulation, and metabolism.…”