Plasma brain-derived tau correlates with cerebral infarct volume

Fernando Gonzalez-Ortiz; Lukas Holmegaard; Björn Andersson; Cecilia Brännmark; Christian Blomstrand; Henrik Zetterberg; Katarina Jood; Kaj Blennow; Christina Jern; Tara M Stanne

doi:10.1111/joim.20041

Plasma brain-derived tau correlates with cerebral infarct volume

J Intern Med. 2024 Dec 5. doi: 10.1111/joim.20041. Online ahead of print.

Authors

Fernando Gonzalez-Ortiz^{1

2}, Lukas Holmegaard^{3

4}, Björn Andersson⁵, Cecilia Brännmark^{6

7}, Christian Blomstrand³, Henrik Zetterberg^{1

2

8

9

10

11}, Katarina Jood^{3

4}, Kaj Blennow^{1

2

12

13}, Christina Jern^{6

14}, Tara M Stanne^{6

14}

Affiliations

¹ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
² Region Västra Götaland, Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
³ Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁴ Region Västra Götaland, Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁵ Bioinformatics and Data Center, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁶ Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁷ Region Västra Götaland, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Östra Hospital, Gothenburg, Sweden.
⁸ Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.
⁹ UK Dementia Research Institute at UCL, London, UK.
¹⁰ Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China.
¹¹ Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
¹² Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.
¹³ Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China and First Affiliated Hospital of USTC, Hefei, China.
¹⁴ Region Västra Götaland, Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden.

PMID: 39639627
DOI: 10.1111/joim.20041

Abstract

Background: A blood-based biomarker that accurately reflects neuronal injury in acute ischemic stroke could be an easily accessible and cost-effective complement to clinical and radiological evaluation. Here, we investigate whether plasma levels of the novel biomarker brain-derived tau (BD-tau) reflect cerebral infarct volumes and whether BD-tau can improve clinical outcome prediction.

Methods: The present study included 713 consecutive cases from two different hospital-based cohorts, the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) and SAHLSIS phase 2 (SAHLSIS2). Acute stroke severity was determined by the Scandinavian Stroke Scale converted to the National Institutes of Health stroke scale (NIHSS) in SAHLSIS and by the NIHSS in SAHLSIS2. All participants were assessed for functional outcome 3 months after stroke by the modified Rankin Scale, and 254 participants in SAHLSIS had quantitative neuroimaging available.

Findings: Plasma BD-tau concentrations and cerebral infarct volumes were highly correlated (ρ 0.72, p < 0.001). BD-tau improved the prognostic accuracy of suffering an unfavorable outcome over age and stroke severity in the whole cohort. However, the gain in predictive power was dependent on stroke severity and infarct location. The largest improvement was observed for mild ischemic strokes (NIHSS <5; area under the curve [AUC] = 0.73 for age + NIHSS versus AUC = 0.84 with addition of BD-tau; DeLong p 0.02), posterior circulation stroke (AUC = 0.75 vs. AUC = 0.84; DeLong p 0.06) and more specifically for infarcts in the brainstem/cerebellum (AUC = 0.74 vs. 0.87; DeLong p 0.009).

Conclusion: Plasma BD-tau can provide information on the extent of acute neuronal damage in ischemic stroke and adds prognostic value for outcome, especially for mild and posterior circulation strokes.

Keywords: blood biomarkers; brain‐derived tau; infarct volume; stroke; stroke severity.

Abstract

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