Longitudinal changes in blood-based biomarkers in chronic moderate to severe traumatic brain injury: preliminary findings

Caroline Schnakers, James Divine, Micah A. Johnson, Evan Lutkenhoff, Martin M. Monti, Katrina M. Keil, John Guthrie, Nader Pouratian, David Patterson, Gary Jensen, Vanessa C. Morales, Kathleen F. Weaver, Emily R. Rosario

Research output: Contribution to journalArticlepeer-review


Objectives: This longitudinal study aims at 1) providing preliminary evidence of changes in blood-based biomarkers across time in chronic TBI and 2) relating these changes to outcome measures and cerebral structure and activity. Methods: Eight patients with moderate-to-severe TBI (7 males, 35 ± 7.6 years old, 5 severe TBI, 17.52 ± 3.84 months post-injury) were evaluated at monthly intervals across 6 time-points using: a) Blood-based biomarkers (GFAP, NSE, S100A12, SDBP145, UCH-L1, T-tau, P-tau, P-tau/T-tau ratio); b) Magnetic Resonance Imaging to evaluate changes in brain structure; c) Resting-state electroencephalograms to evaluate changes in brain function; and d) Outcome measures to assess cognition, emotion, and functional recovery (MOCA, RBANS, BDI-II, and DRS). Results: Changes in P-tau levels were found across time [p = .007]. P-tau was positively related to functional [p < .001] and cognitive [p = .006] outcomes, and negatively related to the severity of depression, 6 months later [R = −0.901; p =.006]. P-tau and P-tau/T-tau ratio were also positively correlated to shape change in subcortical areas such as brainstem [T(7) = 4.71, p = .008] and putamen [T(7) = 3.25, p = .012]. Conclusions: Our study provides preliminary findings that suggest a positive relationship between P-tau and the recovery of patients with chronic TBI.

Original languageEnglish (US)
Pages (from-to)285-291
Number of pages7
JournalBrain injury
Issue number3
StatePublished - 2021
Externally publishedYes


  • P-tau
  • Traumatic brain injury
  • blood biomarkers
  • chronic disease

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology


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