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000284030 0247_ $$2pmid$$apmid:41533774
000284030 0247_ $$2ISSN$$a1946-6234
000284030 0247_ $$2ISSN$$a1946-6242
000284030 037__ $$aDZNE-2026-00073
000284030 041__ $$aEnglish
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000284030 1001_ $$00000-0001-7420-9411$$aVlegels, Naomi$$b0
000284030 245__ $$aBrain-derived tau for monitoring brain injury in acute ischemic stroke.
000284030 260__ $$aWashington, DC$$bAAAS$$c2026
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000284030 520__ $$aA 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.
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000284030 650_7 $$2NLM Chemicals$$atau Proteins
000284030 650_7 $$2NLM Chemicals$$aBiomarkers
000284030 650_2 $$2MeSH$$aHumans
000284030 650_2 $$2MeSH$$aMale
000284030 650_2 $$2MeSH$$atau Proteins: blood
000284030 650_2 $$2MeSH$$atau Proteins: metabolism
000284030 650_2 $$2MeSH$$aIschemic Stroke: blood
000284030 650_2 $$2MeSH$$aIschemic Stroke: complications
000284030 650_2 $$2MeSH$$aIschemic Stroke: diagnostic imaging
000284030 650_2 $$2MeSH$$aFemale
000284030 650_2 $$2MeSH$$aAged
000284030 650_2 $$2MeSH$$aBiomarkers: blood
000284030 650_2 $$2MeSH$$aBrain: metabolism
000284030 650_2 $$2MeSH$$aBrain: pathology
000284030 650_2 $$2MeSH$$aMiddle Aged
000284030 650_2 $$2MeSH$$aBrain Injuries: blood
000284030 650_2 $$2MeSH$$aBrain Injuries: complications
000284030 650_2 $$2MeSH$$aProspective Studies
000284030 650_2 $$2MeSH$$aMagnetic Resonance Imaging
000284030 650_2 $$2MeSH$$aTomography, X-Ray Computed
000284030 7001_ $$00009-0001-8912-9366$$aKnuth, Nicoló L$$b1
000284030 7001_ $$00009-0006-8071-2658$$aSteiner, Konstantin A$$b2
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000284030 7001_ $$aReidler, Paul$$b40
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