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Neurosurg Rev. 2018 Apr;41(2):605-614. doi: 10.1007/s10143-017-0900-6. Epub 2017 Sep 10.

Neurodegenerative cerebrospinal fluid biomarkers tau and amyloid beta predict functional, quality of life, and neuropsychological outcomes after aneurysmal subarachnoid hemorrhage.

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Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Department of Clinical Neurological Sciences, Division of Neurosurgery, London Health Sciences Centre, University Hospital, London, ON, Canada.
Center for Laboratory Medicine, St. Gallen, Switzerland.
Department of Neurology, Division of Neuropsychology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.


Cerebrospinal fluid (CSF) biomarkers might be useful in predicting outcome after aneurysmal subarachnoid hemorrhage (aSAH). It was the aim to determine whether tau and amyloid beta CSF concentrations predict functional, health-related quality of life (hrQoL), and neuropsychological outcomes after aSAH. Ventricular CSF was obtained from n = 24 aSAH patients at admission (D0), day 2 (D2), and day 6 (D6). CSF total (t)Tau, phosphorylated (p)Tau(181P), and amyloid beta(1-40 and 1-42) (Aβ40/Aβ42) levels were compared between patients with favorable and unfavorable functional (modified Rankin Scale (mRS)), hrQoL (Euro-Qol (EQ-5D)), and neuropsychological outcomes at 3 (3 m) and 12 months (12 m). Patients with unfavorable functional (mRS 4-6) and hrQoL outcome (EQ-5D z-score ≤ - 1.0) at 3 and 12 m had higher CSF tTau/pTau and lower Aβ40/Aβ42 at D0, D2, and D6 with varying degrees of statistical significance. In terms of predicting neuropsychological outcome, CSF pTau showed a statistically significant correlation with the z-scores of executive function (r = - 0.7486, p = 0.008), verbal memory (r = - 0.8101, p = 0.002), attention (r = - 0.6498, p = 0.030), and visuospatial functioning (r = - 0.6944, p = 0.017) at 3 m. At 12 m, CSF pTau had statistically significant correlations with the z-scores of verbal memory (r = - 0.7473, p = 0.008) and visuospatial functioning (r = - 0.6678, p = 0.024). In conclusion, higher tTau/pTau and lower Aβ40/Aβ42 CSF levels predict unfavorable long-term functional and hrQoL outcomes. Neuropsychological deficits correlate with increased CSF tTau and pTau concentrations.


Amyloid beta protein; Biomarker; Cerebrospinal fluid; Neuropsychological outcome; Subarachnoid hemorrhage; Tau protein

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