title: A prospective pilot study on serum cleaved tau protein as a neurological marker in severe traumatic brain injury.
abstract: OBJECTIVE
  Neurotrauma has been labelled as a "silent epidemic" affecting both the developed and the developing nations. To date, no single brain-specific biomarker has been unanimously accepted for routine clinical use in TBI. Our study aims to determine the correlation of "cleaved-tau protein" in severe traumatic brain injury (TBI) with Glasgow Coma Scale (GCS) at the time of admission, mode of injury, CT findings and outcome at discharge.
  
  
  METHODS
  The study has been approved by the institutional ethical committee. 40 cases with severe TBI and 40 randomly selected healthy controls were included in this prospective study. Venous blood samples were collected and serum cleaved tau protein levels were measured and correlated with gender, mode of injury, CT findings GCS score and GOS score at discharge.
  
  
  RESULTS
  In the severe TBI group, the mean serum cleaved tau protein levels in males were 91.65 ± 41.34 pg/ml (mean ± S.D.), and females were 104.43 ± 53.08 pg/ml (mean ± S.D.), (p = 0.27). Mean serum C-tau level in study group was 95.48 ± 44.87 pg/ml (range 36.44-192.34), 95% C.I. (81.13-109.83) and in controls was 33.82 ± 13.65 pg/ml (range 2.48-66.54), 95% C.I. (29.46-38.19) (p < 0.001). The distribution of serum C-tau was in severe TBI group varied in all categories of GCS at 0th day (p < 0.001). Serum cleaved tau protein levels in the good outcome group were 74.26 ± 25.43 pg/ml (mean ± S.D.), range 36.44-144.54, 95% C.I. (63.52-85.00) and the poor-outcome group were 127.32 ± 49.40 pg/ml, range 66.65-192.34, 95% C.I. (100.99-153.64) (p = 0.001).
  
  
  CONCLUSIONS
  In severe TBI, serum cleaved tau protein levels were significantly higher as compared to the controls in this prospective study. However, results of this study are preliminary in nature and there is a need to undertake larger prospective studies to reach a definitive conclusion.
authors.affiliation: a Department of Neuro Surgery , Sir Sunder Lal Hospital, IMS, BHU , Varanasi , Uttar Pradesh , India.
authors.forename: Sharad
authors.identifier: http://orcid.org/0000-0002-3542-5864
authors.initials: S
authors.lastname: Pandey
authors.affiliation: a Department of Neuro Surgery , Sir Sunder Lal Hospital, IMS, BHU , Varanasi , Uttar Pradesh , India.
authors.forename: Kulwant
authors.initials: K
authors.lastname: Singh
authors.affiliation: a Department of Neuro Surgery , Sir Sunder Lal Hospital, IMS, BHU , Varanasi , Uttar Pradesh , India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Sharma
authors.affiliation: b Department of Clinical Microbiology , Central Hospital DLW , Varanasi , Uttar Pradesh , India.
authors.forename: Deepa
authors.initials: D
authors.lastname: Pandey
authors.affiliation: c Department of Community Medicine, Division of Biostatics , Sir Sunder Lal Hospital, IMS BHU , Varanasi , Uttar Pradesh , India.
authors.forename: Ravi Prakash
authors.initials: RP
authors.lastname: Jha
authors.affiliation: d Department of Anatomy , Sir Sunder Lal Hospital, IMS BHU , Varanasi , Uttar Pradesh , India.
authors.forename: Sunil Kumar
authors.initials: SK
authors.lastname: Rai
authors.affiliation: e Department of Radio diagnosis , Sir Sunder Lal Hospital, IMS BHU , Varanasi , Uttar Pradesh , India.
authors.forename: Richa Singh
authors.initials: RS
authors.lastname: Chauhan
authors.affiliation: d Department of Anatomy , Sir Sunder Lal Hospital, IMS BHU , Varanasi , Uttar Pradesh , India.
authors.forename: Royana
authors.initials: R
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D000070642:Brain Injuries, Traumatic / Q000097:blood / Q000175:diagnosis*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult; D016875:tau Proteins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D016875:tau Proteins
keywords: Biochemical marker; Glasgow Coma Scale score; Glasgow outcome score; cleaved-tau protein; severe TBI