Serum cleaved tau does not predict postconcussion syndrome after mild traumatic brain injury

Abstract

Objectives Our objective was to determine if the biomarker for axonal injury, serum cleaved-tau (C-tau), predicts PCS in adults after mild traumatic brain injury (mTBI). Methods C-tau was measured from blood obtained in the emergency department. Outcome was assessed at three months post-injury using the Rivermead Postconcussion Symptoms Questionnaire (RPQ) and Acute Medical Outcomes SF-36v2™ Health Survey (SF-36). Results Out of 50 patients, there were 15 patients with detectable levels of C-tau, 10 patients with abnormal findings on initial head CT and 22 patients with PCS. One-third of patients with detectable C-tau and 14.3% of patients without detectable C-tau had abnormal findings on head CT (p=0.143). Serum C-tau was not detected more frequently in patients with PCS than those without, neither for all patients (p=0.115) nor the subgroup with negative head CT scans (p=0.253). Conclusions C-tau is a poor predictor of PCS after mTBI regardless of head CT scan result.

Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging

“…Various studies diagnose patients with PCS with symptoms lasting 1 month; however, we adhered to the temporal DSM-IV definition of PCS as being symptomatic for longer than 3 months [13][14][15][16][17]. While the DSM-V has been published [18], we chose the DSM-IV definition as it was the temporal definition during the study period.…”

Mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions

“…126 Questions remain, however, with several studies reporting little or no value of serum cleaved tau for predicting post-concussion syndrome or long-term outcomes. 130,151 The potential of tau as a biomarker in children remains unclear, with no studies conducted to date. In fact, the reliability of serum tau as a biomarker has not yet been established for any indication.…”

Effects of concussion on the blood–brain barrier in humans and rodents

“…[58][59][60][61] NSE, similar to S-100b, has a very variable sensitivity ranging from 40 to 89%, making it too insensitive to diagnose mTBI, and does not reliably provide prognostic information on mTBIs. [62][63][64][65] Similarly, CTP has not been found to significantly differ between control subjects and those with mTBI. 66,67 UCH-L1 has also been demonstrated to be elevated in TBI patients, with less severe TBI (GCS of 6-8) being associated with lower UCH-L1 levels in CSF.…”