Association of Marshall CT Scores with GFAP, UCH-L1, Tau, NfL, and p-Tau231 After Traumatic Brain Injury

This study identifies a significant association among blood-based biomarkers of traumatic brain injury (TBI) and the Marshall CT classification of TBI (MCTC) scores, but not with Glasgow Coma Scale (GCS) scores. We aimed to determine whether GCS and MCTC scores relate to glial fibrillary acid protein (GFAP), ubiquitin carboxy hydrolase-1 (UCH-L1), tau, neurofilament light chain (NfL), and phosphorylated tau (p-tau231) concentrations following acute TBIs. Participants included patients from 20 trauma centers across 12 regional sites in the United States and Canada with an initial CT scan within 6 h after TBI and GCS scores of 3 to 12. Blood samples collected upon hospital arrival were analyzed for biomarker concentrations (pg/mL). Concentrations from 271 patients with GCS ≥ 9 were compared to 145 with GCS ≤ 9. Samples from 347 patients with MCTC < 3 were compared to 70 with MCTC ≥ 3. No significant differences in GCS groups were found (p's > 0.5), while MCTC groups differed significantly (p's < 0.001). Higher concentrations of plasma GFAP, NfL, and p-tau231 correlated with MCTC scores > 3, with no associations with GCS. Future research might show an application in individual risk assessments to improve triaging of TBI patients.