Journal of Neurology

, Volume 251, Issue 7, pp 870–876 | Cite as

Marked increase of β-amyloid(1–42) and amyloid precursor protein in ventricular cerebrospinal fluid after severe traumatic brain injury

  • Annika Olsson
  • Ludvig Csajbok
  • Martin Öst
  • Kina Höglund
  • Karin Nylén
  • Lars Rosengren
  • Bengt Nellgård
  • Kaj Blennow


Severe traumatic brain injury (TBI) may result in widespread damage to axons, termed diffuse axonal injury. Alzheimer’s disease (AD) is characterised by synaptic and axonal degeneration together with senile plaques (SP). SP are mainly composed of aggregated β-amyloid (Aβ), which are peptides derived from the amyloid precursor protein (APP). Apart from TBI in itself being considered a risk factor for AD, severe head injury seems to initiate a cascade of molecular events that are also associated with AD. We have therefore analysed the 42 amino acid forms of Aβ (Aβ(1–42)) and two soluble forms of APP (α-sAPP and ßsAPP) in ventricular cerebrospinal fluid (VCSF) and Aβ(1–42) in plasma from 28 patients in a serial samples 0–11 days after TBI. The levels of α-sAPP, ß-sAPP and Aβ(1–42) were determined using ELISA assays. After TBI, there was a significant stepwise increase in VCSF-Aβ(1–42) up to 1173 % from day 0–1 to day 5–6 and in VCSF-β-sAPP up to 2033 % increase from day 0–1 to day 7–11. There was also a slight but significant increase of VCSF-β-sAPP from day 0–1 to day 5–6 and day 7–11. By contrast, the plasma- Aβ(1–42) level is unchanged after injury. The marked increase in VCSFAβ( 1–42) implies that increased Aβ expression may occur as a secondary phenomenon after TBI with axonal damage. The unchanged level of plasma-Aβ(1–42) in contrast to the marked increase in VCSF-Aβ(1–42) after severe TBI, supports the suggestion that plasma Aβ(1–42) does not reflect Aβ metabolism in the central nervous system (CNS).

Key words

Alzheimer’s disease amyloid precursor protein β-amyloid cerebrospinal fluid traumatic brain injury 




Alzheimer’s disease


amyloid precursor-like proteins


amyloid precursor protein


blood brain barrier


computed tomography


central nervous system


gracile axonal dystrophy


Glasgow Coma Scale


intracranial pressure


magnetic resonance imaging


ventricular cerebrospinal fluid


soluble amyloid precursor protein


traumatic brain injury


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Copyright information

© Steinkopff Verlag 2004

Authors and Affiliations

  • Annika Olsson
    • 1
  • Ludvig Csajbok
    • 2
  • Martin Öst
    • 2
  • Kina Höglund
    • 1
  • Karin Nylén
    • 3
  • Lars Rosengren
    • 3
  • Bengt Nellgård
    • 2
  • Kaj Blennow
    • 1
  1. 1.Institute of Clinical Neuroscience SectionSahlgrenska University Hospital/MölndalMölndalSweden
  2. 2.Department of Anaesthesia and Intensive Care MedicineSahlgrenska University HospitalGöteborgSweden
  3. 3.Institute of Clinical NeuroscienceSahlgrenska University HospitalGöteborgSweden

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