Diagnostic value of S100B and neuron-specific enolase in mild pediatric traumatic brain injury

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>During recent years, several biomarkers have been introduced for use in the diagnosis of traumatic brain injury (TBI). The primary objective of this investigation was to determine if S100B (or S100 calcium-binding protein B) and neuron-specific enolase (NSE) serum concentrations can effectively be used to discriminate between symptomatic and asymptomatic children with minor head trauma.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The authors conducted a prospective clinical study that involved patients age 6 months to 15 years who had sustained minor head trauma. Children with concomitant extracranial injuries were excluded. Blood samples were obtained within 6 hours of injury to measure S100B and NSE levels in serum. The authors defined 2 diagnostic groups: a mild TBI group (patients with Glasgow Coma Scale [GCS] scores of 13–15) in whom there were clinical signs of concussion (short loss of consciousness, amnesia, nausea, vomiting, somnolence, headache, dizziness, or impaired vision) and a head contusion group (patients with a GCS score of 15) in whom symptoms were absent. Both S100B and NSE concentrations were compared between the 2 groups. Secondary end points were defined as follows: correlation of S100B/NSE and a) the presence of scalp lacerations, b) GCS score, c) age, and d) correlation between S100B and NSE.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>One hundred forty-eight patients were enrolled (53 in the contusion group, 95 in the mild TBI group). After adjusting for differences in age and time of injury to blood sample withdrawal, there was no significant difference in S100B or NSE between patients in the 2 groups. Scalp lacerations and GCS score had no affect on posttraumatic S100B or NSE concentrations. The correlation between S100B and NSE was significant. Both markers showed a significant negative correlation with age.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The authors demonstrated that S100B and NSE do not discriminate between symptomatic and asymptomatic children with minor head injury. There seem to be limitations in marker sensitivity when investigating pediatric patients with mild TBI.</jats:p></jats:sec>

Mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions

“…[134][135][136] Neuron-specific enolase (NSE) is a marker of neuronal injury, but its usefulness as a serum or CSF biomarker remains uncertain. [133][134][135][136][137] Elevated serum NSE levels have been observed after head impacts in boxers, 124 but were also seen in ice hockey players after a match where no concussions occurred. 126 Serum NSE levels failed to predict recovery time after concussion, 126 and might not correlate with injury severity in children.…”

“…132 In a study of children with TBI aged ≤15 years, those <5 years or >9 years of age had higher serum levels of S100B than did those aged 5-9 years. 133 S100B may, therefore, be an inadequate marker to distinguish between symptomatic and asymptomatic children with concussion, 133 and the utility of S100B in diagnostics and outcome prognosis is questionable. [134][135][136] Neuron-specific enolase (NSE) is a marker of neuronal injury, but its usefulness as a serum or CSF biomarker remains uncertain.…”

“…126 Serum NSE levels failed to predict recovery time after concussion, 126 and might not correlate with injury severity in children. 133 In children aged ≤15 years, serum NSE levels correlate inversely with age. 133 Once released into the blood, NSE has slow elimination kinetics, making it difficult to distinguish primary from secondary neuronal injuries on the basis of NSE levels.…”

“…133 In children aged ≤15 years, serum NSE levels correlate inversely with age. 133 Once released into the blood, NSE has slow elimination kinetics, making it difficult to distinguish primary from secondary neuronal injuries on the basis of NSE levels. 138,139 Neurofilament light chain and glial fibrillary acidic protein (GFAP) are CSF neuron-specific and glialspecific damage markers, respectively, and are both elevated in CSF in adult boxers after fights.…”

The role of blood S100B and lactate levels in minor head traumas in children and adults and correlation with brain computerized tomography

“…Özellikle çocuk hastalarda bazal serum S100B seviyesinin belirlenmesini en çok etkileyen parametre hastanın yaşıdır. Geyer ve arkadaşları [4] 1004 çocukta normal serum S100B seviyelerini incelemiş ve referans eğrisini çizmiştir. Gazzolo, [5] bir yaşının altında diğeri ergen dönemde olan iki pik bulmuştur.…”