Serum brain-derived tau in lacunar stroke and cerebral small vessel disease.
4 affiliations
- 1Department of Neurology, Medical University of Graz, Graz, Austria.
- 2Department of Neurology, University Hospital Wiener Neustadt - Hochegg, Wiener Neustadt, Austria.
- 3Department of Medicine, Danube Private University, Krems, Austria.
- 4Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Abstract
Introduction
Brain-derived tau (BD-tau) selectively quantifies tau of central nervous system origin in blood and has demonstrated strong correlations with infarct volume and functional outcome in general ischaemic stroke, but data in lacunar stroke and cerebral small vessel disease (CSVD) are lacking.Patients and methods
In a prospectively collected cohort of 101 lacunar stroke patients with an MRI-confirmed recent small subcortical infarct (RSSI) and 47 controls, we measured serum BD-tau using the HD-X SIMOA platform at baseline and 3 and 15 months after stroke. We examined associations of BD-tau with infarct size, chronic CSVD neuroimaging features (white matter hyperintensities [WMHs], lacunes, microbleeds, total SVD score), CSVD progression on follow-up MRI and functional outcome.Results
Baseline serum BD-tau was higher in RSSI patients than controls (median 9.54 [7.32-12.20] vs 7.75 [6.18-9.44] pg/mL; P = .003) and correlated with infarct diameter (rs = 0.222, P = 0.039). Brain-derived tau did not correlate with time from stroke symptom onset to blood sampling (rs = 0.150, P = .179). Brain-derived tau was not associated with chronic CSVD neuroimaging features (WMHs, lacunes, microbleeds, SVD score; all P > .05) at any timepoint. Longitudinally, BD-tau returned to control levels by 3 months (P = .374) and remained stable at 15 months (P = .985). Brain-derived tau was neither associated with new vascular MRI lesions on follow-up nor functional neurological outcome.Conclusion
Serum BD-tau is elevated acutely in CSVD-related RSSI, correlates with infarct size and normalises by 3 months. Brain-derived tau was not associated with chronic CSVD neuroimaging features or disease progression, suggesting sensitivity to acute neuronal injury rather than chronic or progressive CSVD.
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BibTeX
@article{gattringer2026serum,
title = {{Serum brain-derived tau in lacunar stroke and cerebral small vessel disease.}},
author = {Thomas Gattringer and Melanie Haidegger and Cansu Tafrali and Maria Martinez-Serrat and Daniela Pinter and Simon Fandler-Höfler and Markus Kneihsl and Stephan Seiler and Sebastian Eppinger and Christian Kiss and Roberta Bichler and Michaela T Haindl and Stefan Ropele and Christian Enzinger and Michael Khalil},
journal = {European stroke journal},
year = {2026},
month = nov,
doi = {10.1093/esj/aakag133},
url = {https://europepmc.org/article/MED/42969846},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Serum brain-derived tau in lacunar stroke and cerebral small vessel disease.
AU - Thomas Gattringer
AU - Melanie Haidegger
AU - Cansu Tafrali
AU - Maria Martinez-Serrat
AU - Daniela Pinter
AU - Simon Fandler-Höfler
AU - Markus Kneihsl
AU - Stephan Seiler
AU - Sebastian Eppinger
AU - Christian Kiss
AU - Roberta Bichler
AU - Michaela T Haindl
AU - Stefan Ropele
AU - Christian Enzinger
AU - Michael Khalil
PY - 2026
DA - 2026/11/01
JO - European stroke journal
DO - 10.1093/esj/aakag133
UR - https://europepmc.org/article/MED/42969846
AB - Introduction Brain-derived tau (BD-tau) selectively quantifies tau of central nervous system origin in blood and has demonstrated strong correlations with infarct volume and functional outcome in general ischaemic stroke, but data in lacunar stroke and cerebral small vessel disease (CSVD) are lacking.Patients and methods In a prospectively collected cohort of 101 lacunar stroke patients with an MRI-confirmed recent small subcortical infarct (RSSI) and 47 controls, we measured serum BD-tau using the HD-X SIMOA platform at baseline and 3 and 15 months after stroke. We examined associations of BD-tau with infarct size, chronic CSVD neuroimaging features (white matter hyperintensities [WMHs], lacunes, microbleeds, total SVD score), CSVD progression on follow-up MRI and functional outcome.Results Baseline serum BD-tau was higher in RSSI patients than controls (median 9.54 [7.32-12.20] vs 7.75 [6.18-9.44] pg/mL; P = .003) and correlated with infarct diameter (rs = 0.222, P = 0.039). Brain-derived tau did not correlate with time from stroke symptom onset to blood sampling (rs = 0.150, P = .179). Brain-derived tau was not associated with chronic CSVD neuroimaging features (WMHs, lacunes, microbleeds, SVD score; all P > .05) at any timepoint. Longitudinally, BD-tau returned to control levels by 3 months (P = .374) and remained stable at 15 months (P = .985). Brain-derived tau was neither associated with new vascular MRI lesions on follow-up nor functional neurological outcome.Conclusion Serum BD-tau is elevated acutely in CSVD-related RSSI, correlates with infarct size and normalises by 3 months. Brain-derived tau was not associated with chronic CSVD neuroimaging features or disease progression, suggesting sensitivity to acute neuronal injury rather than chronic or progressive CSVD.
SN - 2396-9873
SN - 2396-9881
ER -