Just like analyzing weather patterns can predict a storm, scientists have discovered that measuring levels of plasma phosphorylated-tau181 (p-tau181) can predict post-stroke cognitive impairment. This blood biomarker, along with other neurodegeneration markers such as amyloid-beta (Aβ), tau, and brain-derived neurotrophic factor (BDNF), can help determine the risk of cognitive decline after a stroke. In a longitudinal study, researchers followed adult patients who experienced their first-ever stroke, evaluating their cognitive and functional abilities. They found that patients with high levels of acute plasma p-tau181 had a significantly lower risk of cognitive impairment both at 3 and 12 months after the stroke. The p-tau181 level also improved the ability to predict cognitive impairment at these time points. Interestingly, the study revealed different patterns of plasma p-tau181 levels among subjects with and without cognitive impairment, suggesting its potential as an indicator for timely intervention. These findings highlight the importance of identifying biomarkers to anticipate and address the cognitive consequences of stroke. For more details on this fascinating study, check out the research article.

IntroductionPost-stroke cognitive impairment (PSCI) cannot be neglected because it drastically influences the daily life of patients and their families. However, there are no studies exploring the association between preclinical blood biomarkers of neurodegeneration including plasma amyloid-β (Aβ), tau, and brain-derived neurotrophic factor (BDNF) together with the risk of PSCI. This longitudinal study was to investigate whether these blood biomarkers with imaging markers of cerebral small vessel disease can improve the prediction for PSCI. In addition, we also explored the association between blood biomarkers with the trajectories of PSCI.MethodsAdult patients with first-ever acute ischemic stroke were recruited, and the cognitive and functional abilities of these patients were evaluated. Furthermore, blood biomarkers of neurodegeneration including plasma Aβ-40, Aβ-42, total tau, phosphorylated tau 181 (p-tau181), and BDNF levels and image markers of cerebral small vessel disease were measured. Each patient was followed up at 3 and 12 months at the outpatient department.ResultsOf 136 patients, 40 and 50 patients developed PSCI at 3 and 12 months after stroke, respectively. In functional trajectories, 27 patients did not have PSCI at 3 months but did at 12 months. By contrast, the PSCI status of 17 patients at 3 months was reversed at 12 months. Patients with high-acute plasma p-tau181 had a significantly lower PSCI risk at 3 months (odds ratio [OR] = 0.62, 95% CI = 0.40–0.94, p = 0.0243) and 12 months (OR = 0.69, 95% CI = 0.47–0.99, p = 0.0443) after adjustment for covariates and image biomarkers. Discrimination and reclassification statistics indicated that the p-tau181 level can improve discrimination ability for PSCI at 3 and 12 months, respectively. In addition, the plasma p-tau181 level was the highest in subjects without PSCI followed by those with delayed-onset PSCI and early-onset PSCI with reversal, whereas the lowest plasma p-tau181 level was found among those with persistent PSCI, showing a significant trend test (p = 0.0081).ConclusionPlasma p-tau181 is a potential biomarker for predicting early- and delayed-onset PSCI. Future studies should incorporate plasma p-tau181 as an indicator for timely cognitive intervention in the follow-up of patients with stroke.

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