Journal
NEUROPSYCHOPHARMACOLOGY
Volume -, Issue -, Pages -Publisher
SPRINGERNATURE
DOI: 10.1038/s41386-022-01359-5
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Funding
- National Institutes of Health [U01NS086090]
- US Department of Defense [W81XWH-14-2-0176]
- TRACK-TBI Precision Medicine [W81XWH-18-2-0042]
- TRACK-TBI NETWORK [W81XWH15-9-0001, W81XWH-15-9-0001]
- NIH-NINDS-TRACK-TBI [U01NS086090]
- National Football League (NFL) Scientific Advisory Board -TRACK-TBI LONGITUDINAL
- United States Department of Energy
- NeuroTrauma Sciences LLC
- Department of Defense TBI Endpoints Development Initiative [W81XWH-14-2-0176]
- National Football League Players Association
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This study aimed to determine whether two day-of-injury blood-based biomarkers are predictive of posttraumatic stress disorder (PTSD). The results showed that elevated day-of-injury serum GFAP levels are associated with a reduced risk of PTSD after mild TBI.
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 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. Serum 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 serum 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.
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