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Amyloid beta 1-42 and tau in cerebrospinal fluid after severe traumatic brain injury

From the Departments of Neurology (Drs. Franz, Beer, Kampfl, Engelhardt, Schmutzhard, and Deisenhammer) and Biostatistics (Dr. Ulmer), University of Innsbruck, Austria.

Address correspondence and reprint requests to Dr. Florian Deisenhammer, Department of Neurology, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria; e-mail: florian.deisenhammer{at}uibk.ac.at

Objective: To determine whether CSF amyloid beta 1-42 (Aß-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. Aß-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 Aß-42 were significantly lower in patients with traumatic brain injury (TBI) than in control groups. A significant correlation existed for Aß-42 levels and outcome of patients. Below a cutoff of 230 pg/mL, the sensitivity of Aß-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: Aß-42 and tau may play a potential role in the pathophysiology of TBI. Furthermore, the results of this study suggest that Aß-42 may be a supportive early predictor for recovery after severe head injury.

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