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Brain-derived tau for monitoring brain injury in acute ischemic stroke

Title: Brain-derived tau for monitoring brain injury in acute ischemic stroke
Authors: Vlegels, Naomi; Knuth, Nicoló L.; Steiner, Konstantin A.; Zhang, Linjie; Vix, Apolline L.; Moumin, Dilara; Mirzen, Irem; Khalifeh, Nada; Forster, Charlotte; Gesierich, Benno; Müller, Franziska; Lohse, Philipp; Filler, Jule; Fang, Rong; Klein, Matthias; Dimitriadis, Konstantinos; Franzmeier, Nicolai; Liebig, Thomas; Endres, Matthias; Goertler, Michael; Stockero, Andrea; DEMDAS study group; ESCAPE-NEXT biomarker substudy investigators‡
Contributors: Vlegels, Naomi; Knuth, Nicoló L.; Steiner, Konstantin A.; Zhang, Linjie; Vix, Apolline L.; Moumin, Dilara; Mirzen, Irem; Khalifeh, Nada; Forster, Charlotte; Gesierich, Benno; Müller, Franziska; Lohse, Philipp; Filler, Jule; Fang, Rong; Klein, Matthias; Dimitriadis, Konstantinos; Franzmeier, Nicolai; Liebig, Thomas; Endres, Matthias; Goertler, Michael; Stockero, Andrea; DEMDAS study group; ESCAPE-NEXT biomarker substudy investigators‡
Publication Year: 2026
Collection: Georg-August-Universität Göttingen: GoeScholar
Description: A specific and accurate blood test for acute brain injury could help monitor infarct growth in ischemic stroke and serve as a surrogate end point in clinical trials. Using a single-molecule detection assay, we assessed plasma brain-derived tau (BD-tau), a marker selectively quantifying tau protein from the central nervous system, in a prospective cohort of 502 patients with acute ischemic stroke with serial blood sampling from admission to day 7. Higher BD-tau concentrations at admission were associated with more extensive early brain injury on computed tomography and predicted larger final infarct volumes. BD-tau increases from admission to day 2 were related to infarct growth. BD-tau concentrations rose until day 7 and were higher in patients with secondary events, including recurrent stroke. After thrombectomy, the rise of BD-tau was smaller in patients with complete versus incomplete recanalization. BD-tau outperformed other blood markers and imaging metrics in predicting 90-day functional outcome across infarct size strata and time points. In an independent multicenter prospective cohort ( N = 519), BD-tau showed higher performance than magnetic resonance imaging–derived final infarct volume in predicting functional outcomes at 3, 12, and 36 months. In the biomarker substudy of a phase 3 trial assessing nerinetide in patients with ischemic stroke ( N = 193), BD-tau showed predictive performance comparable to the other cohorts, mediated the relationship between recanalization and functional outcome, and showed a 49% smaller increase in the nerinetide group versus placebo. Overall, plasma BD-tau tracked ischemic brain injury over time, outperformed other biomarkers in predicting functional outcomes, and identified possible treatment responses. ; Brain-derived tau in plasma reflects the extent of brain injury in acute ischemic stroke, predicts functional outcomes, and detects treatment effects. ; Editor’s summary Blood tests to monitor evolving brain injury in ischemic stroke could be a cost-effective and fast ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1126/scitranslmed.adz1280
Availability: https://resolver.sub.uni-goettingen.de/purl?gro-2/158014; https://doi.org/10.1126/scitranslmed.adz1280
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.47F08442
Database: BASE