1 Defense and Veterans Brain Injury Center, and Walter Reed National Military Medical Center, Bethesda, Maryland.
2 National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland.
J Neurotrauma. 2019 Jul 15;36(14):2190-2199. doi: 10.1089/neu.2018.6269. Epub 2019 Apr 9.
The aim of this study was to examine the relationship between plasma tau and amyloid beta-42 (Aβ42), neuropsychological functioning, and white matter integrity in U.S. military service members with ( = 155) and without ( = 42) a history of uncomplicated mild ( = 83), complicated mild ( = 26), or moderate, severe, or penetrating ( = 46) traumatic brain injury (TBI). We hypothesized that higher levels of tau and Aβ42 would be related to reduced neurocognitive performance and white matter integrity. Participants were enrolled prospectively from Walter Reed National Military Medical Center. Participants completed a blood draw, neuropsychological assessment, and diffusion tensor imaging (General Electric 3T) of the whole brain. From 20 neuropsychological test scores, five cognitive domain scores were computed. Measures of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were generated for 18 regions of interest (ROIs). There was no relationship found between the plasma biomarkers and neurocognitive performance in any of the three TBI groups (all ps >0.05; all R changes <0.146). Although not reaching statistical significance after correction for multiple comparisons, higher tau and Aβ42 tended to be related to higher FA and lower MD, RD, and AD in patients with a history of moderate, severe, or penetrating TBI. There was no consistent relationship between either of the biomarkers and white matter integrity in the complicated and uncomplicated mild TBI groups. In addition, there was no significant relationship between the biomarkers and age, education, sex, race, bodily injury severity, time since injury, TBI severity, or number of TBIs (all ps >0.15). Future investigation in larger samples of moderate, severe, and penetrating TBI are needed. Other plasma biomarkers, including phosphorylated tau, exosomal tau, and interleukin-10, may be more promising measures to use in the diagnosis, management, and treatment of TBI.
这项研究的目的是检验美国军事人员血浆 tau 与淀粉样蛋白β-42（Aβ42）、神经心理学功能和白质完整性之间的关系，其中包括（ = 155）和不包括（ = 42）单纯轻度（ = 83）、复杂轻度（ = 26）或中度、重度或穿透性（ = 46）创伤性脑损伤（TBI）病史的患者。我们假设 tau 和 Aβ42 水平较高与认知功能下降和白质完整性降低有关。参与者前瞻性地从沃尔特·里德国家军事医疗中心招募。参与者完成了血液采集、神经心理学评估和整个大脑的弥散张量成像（通用电气 3T）。从 20 项神经心理学测试评分中，计算了 5 项认知域评分。为 18 个感兴趣区（ROI）生成了分数各向异性（FA）、平均扩散系数（MD）、轴向扩散系数（AD）和径向扩散系数（RD）的测量值。在任何一组 TBI 患者中（所有 ps >0.05；所有 R 变化 <0.146），均未发现血浆生物标志物与神经认知表现之间存在相关性。虽然在进行多次比较校正后未达到统计学意义，但在有中度、重度或穿透性 TBI 病史的患者中，较高的 tau 和 Aβ42 倾向于与较高的 FA 和较低的 MD、RD 和 AD 相关。在单纯性轻度 TBI 组中，两种生物标志物与白质完整性之间均无一致的关系。此外，生物标志物与年龄、教育程度、性别、种族、身体伤害严重程度、受伤后时间、TBI 严重程度或 TBI 次数之间无显著相关性（所有 ps >0.15）。需要在更大的中度、重度和穿透性 TBI 样本中进行进一步研究。其他血浆生物标志物，包括磷酸化 tau、外泌体 tau 和白细胞介素-10，可能是更有前途的 TBI 诊断、管理和治疗指标。
