- 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 KW;
- Temkin, Nancy;
- Mac Donald, Christine L;
- Taylor, Sabrina R;
- Ferguson, Adam R;
- Markowitz, Amy J;
- Diaz-Arrastia, Ramon;
- Manley, Geoffrey T;
- Stein, Murray B
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.