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CSF And Plasma Amyloid-b Temporal Profiles And Relationships With Neurological Status And Mortality After Severe Traumatic Brain Injury

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Nature Scientific Reports | October 10, 2014

Stefania Mondello, Andras Burk, Pal Barzo, Jeff Randall, Gail Provuncher, David Hanlon, David Wilson, Firas Kobeissy & Andreas Jeromin
Nature Scientific Reports
DOI: 10.1038/srep06446

Abstract: The role of amyloid-b (Ab) neuropathology and its significant changes in biofluids after traumatic braininjury (TBI) is still debated. We used ultrasensitive digital  ELISA approach to assess amyloid-b1-42 (Ab42) concentrations and time-course in cerebrospinal fluid (CSF) and in plasma of patients with severe TBI and investigated their relationship to injury characteristics, neurological status and clinical outcome. We found decreased CSF Ab42 levels in TBI patients acutely after injury with lower levels in patients who died 6 months post-injury than in survivors. Conversely, plasma Ab42 levels were significantly increased in TBI with lower levels in patients who survived. A trend analysis showed that both CSF and plasma Ab42 levels strongly correlated with mortality. A positive correlation between changes in CSF Ab42 concentrations and neurological status as assessed by Glasgow Coma Scale (GCS) was identified. Our results suggest that determination of Ab42 may be valuable to obtain prognostic information in patients with severe TBI as well as in monitoring the response of the brain to injury.