Amyloid beta 1-42 and tau in cerebrospinal fluid after severe traumatic brain injury.
OBJECTIVE
To determine whether CSF amyloid beta 1-42 (Abeta-42) and tau have predictive value for prognosis after head injury.


METHODS
CSF samples were collected from 29 patients with severe head trauma between 1 and 284 days post-trauma. Abeta-42 and tau levels were measured using sandwich ELISA techniques and compared with CSF levels in patients with cognitive disorders and headache.


RESULTS
At all time points, concentrations of Abeta-42 were significantly lower in patients with traumatic brain injury (TBI) than in control groups. A significant correlation existed for Abeta-42 levels and outcome of patients. Below a cutoff of 230 pg/mL, the sensitivity of Abeta-42 to discriminate between good outcome (Glasgow Outcome Score 4 and 5) and poor outcome (Glasgow Outcome Score 1 through 3) was 100% at a specificity of 82%. CSF tau levels were significantly higher in patients with TBI than in any control group. In patients with multiple CSF samples collected at various time points between 1 and 32 days after the trauma, tau levels increased early after TBI, peaked in the second week post-trauma, and slowly decreased thereafter. Independent of outcome, all patients had normal tau levels when CSF was collected more than 43 days post-trauma.


CONCLUSIONS
Abeta-42 and tau may play a potential role in the pathophysiology of TBI. Furthermore, the results of this study suggest that Abeta-42 may be a supportive early predictor for recovery after severe head injury.
Department of Neurology, University of Innsbruck, Austria.
G
G
Franz
R
R
Beer
A
A
Kampfl
K
K
Engelhardt
E
E
Schmutzhard
H
H
Ulmer
F
F
Deisenhammer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000209:etiology; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D015415:Biomarkers; D001925:Brain Damage, Chronic / Q000134:cerebrospinal fluid / Q000209:etiology; D001930:Brain Injuries / Q000134:cerebrospinal fluid* / Q000150:complications; D003704:Dementia / Q000134:cerebrospinal fluid; D005260:Female; D015600:Glasgow Coma Scale; D006261:Headache / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000134:cerebrospinal fluid*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016875:tau Proteins / Q000134:cerebrospinal fluid*
D016229:Amyloid beta-Peptides; D015415:Biomarkers; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins