학술논문
Association of day-of-injury plasma glial fibrillary acidic protein concentration and six-month posttraumatic stress disorder in patients with mild traumatic brain injury
Document Type
Original Paper
Author
Kulbe, Jacqueline R.; Jain, Sonia; Nelson, Lindsay D.; Korley, Frederick K.; Mukherjee, Pratik; Sun, Xiaoying; Okonkwo, David O.; Giacino, Joseph T.; Vassar, Mary J.; Robertson, Claudia S.; McCrea, Michael A.; Wang, Kevin K. W.; Temkin, Nancy; Mac Donald, Christine L.; Taylor, Sabrina R.; Ferguson, Adam R.; Markowitz, Amy J.; Diaz-Arrastia, Ramon; Manley, Geoffrey T.; Stein, Murray B.
Source
Neuropsychopharmacology: At the intersection of brain, behavior, and therapeutics. 47(13):2300-2308
Subject
Language
English
ISSN
0893-133X
1740-634X
1740-634X
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.