Biomarkers of Traumatic Brain Injury: Temporal Changes in Body Fluids

Harel, A.; Kvist, Mårten; Salla, Nuutinen; Välimaa, Lasse

doi:10.1523/eneuro.0294-16.2016

Cited by 82 publications

(70 citation statements)

References 152 publications

(160 reference statements)

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“…Despite these findings, we still know little about the exact role of these proteins in the development of persistent symptoms. The kinetics of these biomarkers vary, with S100B and GFAP reaching a peak serum concentration in the first 24 h after injury ('acute biomarkers'), tau staying elevated for days to weeks ('subacute biomarkers'), and NF-L continue rising for weeks to months after injury ('chronic biomarkers') [26]. Therefore, it would be interesting to investigate whether 'acute' biomarkers predict, and if 'chronic' biomarkers accompany long-lasting symptoms.…”

Section: Cellular Injurymentioning

confidence: 99%

An integrated perspective linking physiological and psychological consequences of mild traumatic brain injury

et al. 2019

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Despite the often seemingly innocuous nature of a mild traumatic brain injury (mTBI), its consequences can be devastating, comprising debilitating symptoms that interfere with daily functioning. Currently, it is still difficult to pinpoint the exact cause of adverse outcome after mTBI. In fact, extensive research suggests that the underlying etiology is multifactorial. In the acute and early sub-acute stages, the pathophysiology of mTBI is likely to be dominated by complex physiological alterations including cellular injury, inflammation, and the acute stress response, which could lead to neural network dysfunction. In this stage, patients often report symptoms such as fatigue, headache, unstable mood and poor concentration. When time passes, psychological processes, such as coping styles, personality and emotion regulation, become increasingly influential. Disadvantageous, maladaptive, psychological mechanisms likely result in chronic stress which facilitates the development of long-lasting symptoms, possibly via persistent neural network dysfunction. So far, a systemic understanding of the coupling between these physiological and psychological factors that in concert define outcome after mTBI is lacking. The purpose of this narrative review article is to address how psychophysiological interactions may lead to poor outcome after mTBI. In addition, a framework is presented that may serve as a template for future studies on this subject.

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Section: Cellular Injurymentioning

confidence: 99%

An integrated perspective linking physiological and psychological consequences of mild traumatic brain injury

et al. 2019

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“…Biomarker discovery work in TBI has identified several promising blood protein biomarkers: glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1, neuron specific enolase and S100β (Wang et al, 2018). While these proteins may be useful biomarkers of acute and severe TBI, their use in reliably detecting milder forms of TBI remains to be fully investigated (Adrian et al, 2016;Joseph et al, 2018). At present, there are no blood biomarkers available for PTSD, and only broad inflammatory markers and cerebrospinal fluid (CSF) cortisone levels have been thoroughly examined (Schmidt et al, 2013;Michopoulos et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Plasma Lipidomic Analyses in Cohorts With mTBI and/or PTSD Reveal Lipids Differentially Associated With Diagnosis and APOE ε4 Carrier Status

et al. 2020

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The differential diagnosis between mild Traumatic Brain Injury (mTBI) sequelae and Post-Traumatic Stress Disorder (PTSD) is challenging due to their symptomatic overlap and co-morbidity. As such, there is a need to develop biomarkers which can help with differential diagnosis of these two conditions. Studies from our group and others suggest that blood and brain lipids are chronically altered in both mTBI and PTSD. Therefore, examining blood lipids presents a minimally invasive and cost-effective approach to identify promising biomarkers of these conditions. Using liquid chromatography-mass spectrometry (LC-MS) we examined hundreds of lipid species in the blood of healthy active duty soldiers (n = 52) and soldiers with mTBI (n = 21), PTSD (n = 34) as well as co-morbid mTBI and PTSD (n = 13) to test whether lipid levels were differentially altered with each. We also examined if the apolipoprotein E (APOE) ε4 allele can affect the association between diagnosis and peripheral lipid levels in this cohort. We show that several lipid classes are altered with diagnosis and that there is an interaction between diagnosis and the ε4 carrier status on these lipids. Indeed, total lipid levels as well as both the degree of unsaturation and chain lengths are differentially altered with diagnosis and ε4 status, specifically long chain unsaturated triglycerides (TG) and both saturated and mono-unsaturated diglycerides (DG). Additionally, an examination of lipid species reveals distinct profiles in each diagnostic group stratified by ε4 status, mainly in TG, saturated DG species and polyunsaturated phosphatidylserines. In summary, we show that peripheral lipids are promising biomarker candidates to assist with the differential diagnosis of mTBI and PTSD. Further, ε4 carrier status alone and in interaction with diagnosis has a strong influence on peripheral lipid levels. Therefore, examining ε4 status along with peripheral lipid levels could help with differential diagnosis of mTBI and PTSD.

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“…Certain biomarkers hold promising potential for rapid early detection of traumatic brain injury (TBI) and neurogenic shock, although no studies with a specific subset of trauma patients have been performed. TBI can often be difficult to assess, as GCS can rapidly decline and standard neurological imaging may poorly characterize minor or occult injuries which could later contribute to clinical decline [56]. S100β is a neurologically derived calcium-binding protein which has increased serum expression following traumatic brain and orthopedic injuries and has also been used to rule out TBI due to its strong negative predictive value [56,57].…”

Section: Novel Biomarkers In Traumatic Shockmentioning

confidence: 99%

Resuscitation Endpoints in Traumatic Shock: A Focused Review with Emphasis on Point-of-Care Approaches

Kelley¹,

Dammann²,

Alers³

et al. 2020

Clinical Management of Shock - The Science and Art of Physiological Restoration

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Trauma resuscitation is a blend of art and science, with the traumatologist at the helm of a large, multidisciplinary team, making split-second decisions and overseeing various parallel processes. Despite tremendous progress over the past few decades, the "art" component continues to play a large part in the overall trauma resuscitation process, with the "science" part slowly but steadily increasing its footprint as a determinant of processes and decisions. Thus, it becomes critical for all clinicians to be able to recognize the evidence-based factors which can be most valuable in guiding trauma resuscitations. This chapter serves as an overview of the current clinical findings, resuscitative endpoints, imaging techniques, and physiologic indices that are most helpful in order to promptly recognize and treat traumatic shock as well as projecting forward to look at novel techniques and biomarkers. Though a single universal marker that accurately and consistently identifies traumatic shock has yet to be discovered, certain factors discussed, such as lactate and base deficit, have been proven to be much more reliable than others.

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Biomarkers of Traumatic Brain Injury: Temporal Changes in Body Fluids

Cited by 82 publications

References 152 publications

An integrated perspective linking physiological and psychological consequences of mild traumatic brain injury

An integrated perspective linking physiological and psychological consequences of mild traumatic brain injury

Plasma Lipidomic Analyses in Cohorts With mTBI and/or PTSD Reveal Lipids Differentially Associated With Diagnosis and APOE ε4 Carrier Status

Resuscitation Endpoints in Traumatic Shock: A Focused Review with Emphasis on Point-of-Care Approaches

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