Association of day-of-injury plasma glial fibrillary acidic protein concentration and six-month posttraumatic stress disorder in patients with mild traumatic brain injury.

Abstract

Several proteins have proven useful as blood-based biomarkers to assist in evaluation and management of traumatic brain injury (TBI). The objective of this study was to determine whether two day-of-injury blood-based biomarkers are predictive of posttraumatic stress disorder (PTSD). We used data from 1143 individuals with mild TBI (mTBI; defined as admission Glasgow Coma Scale [GCS] score 13-15) enrolled in TRACK-TBI, a prospective longitudinal study of level 1 trauma center patients. Plasma glial fibrillary acidic protein (GFAP) and serum high sensitivity C-reactive protein (hsCRP) were measured from blood collected within 24 h of injury. Two hundred and twenty-seven (19.9% of) patients had probable PTSD (PCL-5 score ≥ 33) at 6 months post-injury. GFAP levels were positively associated (Spearman's rho = 0.35, p < 0.001) with duration of posttraumatic amnesia (PTA). There was an inverse association between PTSD and (log)GFAP (adjusted OR = 0.85, 95% CI 0.77-0.95 per log unit increase) levels, but no significant association with (log)hsCRP (adjusted OR = 1.11, 95% CI 0.98-1.25 per log unit increase) levels. Elevated day-of-injury plasma GFAP, a biomarker of glial reactivity, is associated with reduced risk of PTSD after mTBI. This finding merits replication and additional studies to determine a possible neurocognitive basis for this relationship.

• Authors: Jacqueline R Kulbe, Sonia Jain, Lindsay D Nelson, Frederick K Korley, Pratik Mukherjee, Xiaoying Sun, David O Okonkwo, Joseph T Giacino, Mary J Vassar, Claudia S Robertson, Michael A McCrea, Kevin K W Wang, Nancy Temkin, Christine L Mac Donald, Sabrina R Taylor, Adam R Ferguson, Amy J Markowitz, Ramon Diaz-Arrastia, Geoffrey T Manley, Murray B Stein, TRACK-TBI Investigators
• Journal: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology (Neuropsychopharmacology) Vol. 47 Issue 13 Pg. 2300-2308 (12 2022) ISSN: 1740-634X [Electronic] England
• PMID: 35717463 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, N.I.H., Extramural)
• Copyright: © 2022. The Author(s).

Chemical References

• Glial Fibrillary Acidic Protein
• C-Reactive Protein
• Biomarkers

Topics

• Humans
• Glial Fibrillary Acidic Protein
• Brain Concussion (complications)
• Stress Disorders, Post-Traumatic
• Prospective Studies
• Longitudinal Studies
• C-Reactive Protein
• Brain Injuries, Traumatic (complications)
• Biomarkers