Neurodegenerative CSF-Biomarkers Tau and Amyloid Beta Predict Functional, Neuropsychological, and Quality of Life Outcomes after Aneurysmal Subarachnoid Hemorrhage

Aims: To determine whether Tau and Amyloid β CSF-concentrations predict functional, neuropsychological and health-related quality of life (hrQoL) outcomes after aSAH.

Methods: Ventricular CSF was obtained from n = 24 aSAH patients at admission (D0), day 2 (D2) and day 6 (D6). CSF total (t)Tau, phosphorylated (p)Tau(181P), Amyloid β(1–40 and 1–42) (Aβ40/Aβ42) levels were compared between patients with favorable and unfavorable functional (modified Rankin Scale (mRS)), neuropsychological, as well as hrQoL outcome (Euro-Qol (EQ- 5D)) at three months (M3) and one year (Y1).

Results: Patients with unfavorable functional outcome (mRS 4–6) at M3 and Y1 had higher CSF tTau/pTau and lower Aβ40/Aβ42 at D0, D2 and D6 with varying degrees of statistical significance. In terms of predicting neuropsychological outcome, CSF pTau showed a strong correlation with the z-scores of executive function (r = −0.7486, p = 0.0080), verbal memory (r = − 0.8101, p = 0.0025), attention (r = −0.6498, p = 0.0304), and visuospatial functioning (r = −0.6944, p = 0.0177) at M3. At Y1, CSF pTau had moderate to strong correlations with the z-scores of executive function (r = −0.5356, p = 0.0895), verbal memory (r = −0.7473, p = 0.0082), attention (r = − 0.4941, p = 0.1224), and visuospatial functioning (r = −0.6678, p = 0.0247). Patients with unfavorable hrQoL outcome (EQ-5D z-score ≤ −1.0) at the M3 and Y1 follow-up had higher CSF tTau/pTau and lower Aβ40/Aβ42 at D0, D2 and D6 of varying degrees of statistical significance.

Conclusions: Higher tTau/pTau as well as lower Aβ40/Aβ42 CSF-levels predict unfavorable long-term functional and hrQoL outcomes. Neuropsychological deficits correlate with increased CSF tTau and pTau concentrations.