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Transl. Med."],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:p>\n                    A specific and accurate blood test for acute brain injury could help monitor infarct growth in ischemic stroke and serve as a surrogate end point in clinical trials. Using a single-molecule detection assay, we assessed plasma brain-derived tau (BD-tau), a marker selectively quantifying tau protein from the central nervous system, in a prospective cohort of 502 patients with acute ischemic stroke with serial blood sampling from admission to day 7. Higher BD-tau concentrations at admission were associated with more extensive early brain injury on computed tomography and predicted larger final infarct volumes. BD-tau increases from admission to day 2 were related to infarct growth. BD-tau concentrations rose until day 7 and were higher in patients with secondary events, including recurrent stroke. After thrombectomy, the rise of BD-tau was smaller in patients with complete versus incomplete recanalization. BD-tau outperformed other blood markers and imaging metrics in predicting 90-day functional outcome across infarct size strata and time points. In an independent multicenter prospective cohort (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    \u00a0=\u00a0519), BD-tau showed higher performance than magnetic resonance imaging\u2013derived final infarct volume in predicting functional outcomes at 3, 12, and 36 months. In the biomarker substudy of a phase 3 trial assessing nerinetide in patients with ischemic stroke (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    \u00a0=\u00a0193), BD-tau showed predictive performance comparable to the other cohorts, mediated the relationship between recanalization and functional outcome, and showed a 49% smaller increase in the nerinetide group versus placebo. Overall, plasma BD-tau tracked ischemic brain injury over time, outperformed other biomarkers in predicting functional outcomes, and identified possible treatment responses.\n                  <\/jats:p>","DOI":"10.1126\/scitranslmed.adz1280","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T18:58:13Z","timestamp":1768417093000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":11,"title":["Brain-derived tau for monitoring brain injury in acute ischemic stroke"],"prefix":"10.1126","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7420-9411","authenticated-orcid":true,"given":"Naomi","family":"Vlegels","sequence":"first","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, 81377 Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8912-9366","authenticated-orcid":true,"given":"Nicol\u00f3 L.","family":"Knuth","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, 81377 Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8071-2658","authenticated-orcid":true,"given":"Konstantin A.","family":"Steiner","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, 81377 Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3002-243X","authenticated-orcid":true,"given":"Linjie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, 81377 Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4621-4801","authenticated-orcid":true,"given":"Apolline L.","family":"Vix","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, 81377 Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6111-1990","authenticated-orcid":true,"given":"Dilara","family":"Moumin","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, 81377 Munich, Germany."},{"name":"Department of Neurology and Stroke, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7376-0846","authenticated-orcid":true,"given":"Irem","family":"Mirzen","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, 81377 Munich, Germany."},{"name":"Department of Neurology and Stroke, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Khalifeh","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, 81377 Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7611-5241","authenticated-orcid":true,"given":"Charlotte","family":"Forster","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU 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