Association of day-of-injury plasma glial ﬁbrillary acidic protein concentration and six-month posttraumatic stress disorder in patients with mild traumatic brain injury

Neuropsychopharmacology, 2022 · DOI: https://doi.org/10.1038/s41386-022-01359-5 · Published: June 18, 2022

Mental Health Bioinformatics Brain Injury

Simple Explanation

This study investigates whether blood-based biomarkers can predict posttraumatic stress disorder (PTSD) in individuals with mild traumatic brain injury (mTBI). The researchers measured plasma glial fibrillary acidic protein (GFAP) and serum high sensitivity C-reactive protein (hsCRP) in blood samples collected within 24 hours of the injury. Interestingly, they found that elevated day-of-injury plasma GFAP was associated with a reduced risk of developing PTSD after mTBI.

Study Duration

Not specified

Participants

1143 individuals with mild TBI

Evidence Level

Prospective longitudinal study

Key Findings

1
Elevated day-of-injury plasma GFAP levels were associated with a reduced risk of PTSD after mTBI.
2
GFAP levels were positively correlated with the duration of posttraumatic amnesia (PTA).
3
hsCRP levels were not significantly associated with PTSD.

Research Summary

This study examined the association between day-of-injury blood biomarkers (GFAP and hsCRP) and the development of PTSD in patients with mild TBI. The results indicated that higher levels of GFAP were unexpectedly associated with a lower risk of developing PTSD at 6 months post-injury. The study suggests that GFAP may play a protective role against PTSD development after mTBI, possibly by interfering with memory encoding and consolidation.

Practical Implications

Clinical awareness

Clinicians should be aware that a low GFAP level does not indicate the absence of health risk to the patient, as risk to mental health may be greatest in those with low GFAP levels.

Future research

Future efforts should focus on using a panel of GFAP and other blood and possibly genetic biomarkers, combined with imaging modalities, to improve prediction of the development of PTSD and related mental disorders following mTBI.

PTSD prediction models

Addition of day-of-injury plasma GFAP improved the performance of previous PTSD prediction models which were based on participant demographics and injury characteristics.

Study Limitations

1
The study was limited to adults and adolescents age 17 and older presenting to level 1 trauma centers who required a head CT scan.
2
The study relied on self-report of prior TBI, prior history of psychiatric illness, and PTA, which could lead to recall and reporting biases.
3
The gold standard for PTSD diagnosis remains a clinical interview that addresses DSM-5 criteria, but this study utilized the self-report PCL-5.

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