TY  - JOUR
AU  - Vlegels, Naomi
AU  - Knuth, Nicoló L
AU  - Steiner, Konstantin A
AU  - Zhang, Linjie
AU  - Vix, Apolline L
AU  - Moumin, Dilara
AU  - Mirzen, Irem
AU  - Khalifeh, Nada
AU  - Forster, Charlotte
AU  - Gesierich, Benno
AU  - Müller, Franziska
AU  - Lohse, Philipp
AU  - Filler, Jule
AU  - Fang, Rong
AU  - Klein, Matthias
AU  - Dimitriadis, Konstantinos
AU  - Franzmeier, Nicolai
AU  - Liebig, Thomas
AU  - Endres, Matthias
AU  - Görtler, Michael
AU  - Petzold, Gabor C
AU  - Wunderlich, Silke
AU  - Zerr, Inga
AU  - Field, Thalia S
AU  - Pham, Mirko
AU  - Swartz, Richard H
AU  - Poli, Sven
AU  - Berrouschot, Jörg
AU  - Zafar, Atif
AU  - Schneider, Hauke
AU  - Shankar, Jai J
AU  - Aamodt, Anne Hege
AU  - Minnerup, Jens
AU  - Mandzia, Jennifer L
AU  - Reimann, Gernot
AU  - Psychogios, Marios-Nikos
AU  - Mundiyanapurath, Sibu
AU  - Reich, Arno
AU  - Yeo, Leonard L L
AU  - Duering, Marco
AU  - Reidler, Paul
AU  - Goyal, Mayank
AU  - Tymianski, Michael
AU  - Hill, Michael D
AU  - Dichgans, Martin
AU  - Tiedt, Steffen
TI  - Brain-derived tau for monitoring brain injury in acute ischemic stroke.
JO  - Science translational medicine
VL  - 18
IS  - 832
SN  - 1946-6234
CY  - Washington, DC
PB  - AAAS
M1  - DZNE-2026-00073
SP  - eadz1280
PY  - 2026
AB  - 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
KW  - Humans
KW  - Male
KW  - tau Proteins: blood
KW  - tau Proteins: metabolism
KW  - Ischemic Stroke: blood
KW  - Ischemic Stroke: complications
KW  - Ischemic Stroke: diagnostic imaging
KW  - Female
KW  - Aged
KW  - Biomarkers: blood
KW  - Brain: metabolism
KW  - Brain: pathology
KW  - Middle Aged
KW  - Brain Injuries: blood
KW  - Brain Injuries: complications
KW  - Prospective Studies
KW  - Magnetic Resonance Imaging
KW  - Tomography, X-Ray Computed
KW  - tau Proteins (NLM Chemicals)
KW  - Biomarkers (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:41533774
DO  - DOI:10.1126/scitranslmed.adz1280
UR  - https://pub.dzne.de/record/284030
ER  -