Research Reports - Detection of β-amyloid oligomers as a predictor of neurological outcome after brain injury

J Neurosurg. 2013 Mar 29

Gatson JW, Warren V, Abdelfattah K, Wolf S, Hynan LS, Moore C, Diaz-Arrastia R, Minei JP, Madden C, Wigginton JG

Object Traumatic brain injury (TBI) is known to be a risk factor for
Alzheimer-like dementia. In previous studies, an increase in β-amyloid (Aβ)
monomers, such as β-amyloid 42 (Aβ42), in the CSF of patients with TBI has been
shown to correlate with a decrease in amyloid plaques in the brain and improved
neurological outcomes. In this study, the authors hypothesized that the levels of
toxic high-molecular-weight β-amyloid oligomers are increased in the brain and
are detectable within the CSF of TBI patients with poor neurological outcomes.
Methods Samples of CSF were collected from 18 patients with severe TBI (Glasgow
Coma Scale Scores 3-8) and a ventriculostomy. In all cases the CSF was collected
within 72 hours of injury. The CSF levels of neuron-specific enolase (NSE) and
Aβ42 were measured using enzyme-linked immunosorbent assay. The levels of
high-molecular-weight β-amyloid oligomers were measured using Western blot
analysis. Results Patients with good outcomes showed an increase in the levels of
CSF Aβ42 (p = 0.003). Those with bad outcomes exhibited an increase in CSF levels
of β-amyloid oligomers (p = 0.009) and NSE (p = 0.001). In addition, the CSF
oligomer levels correlated with the scores on the extended Glasgow Outcome Scale
(r = -0.89, p = 0.0001), disability rating scale scores (r = 0.77, p = 0.005),
CSF Aβ42 levels (r = -0.42, p = 0.12), and CSF NSE levels (r = 0.70, p = 0.004).
Additionally, the receiver operating characteristic curve yielded an area under
the curve for β-amyloid oligomers of 0.8750 ± 0.09. Conclusions Detection of
β-amyloid oligomers may someday become a useful clinical tool for determining
injury severity and neurological outcomes in patients with TBI.

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