Exploring the Role of Biomarkers for the Diagnosis and Management of Traumatic Brain Injury Patients

Papa, Linda

doi:10.5772/31776

Cited by 15 publications

(15 citation statements)

References 143 publications

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“…They include neuronal cell body injury marker Ubiquitin C-terminal hydrolase-L1 (UCH-L1), breakdown products of axonally enriched aII-spectrin (SBDP150 and SBDP145 produced by necrosis-linked calpain protease and SBDP120 produced by the apoptosis-linked caspase-3 protease), dendritic injury marker microtubule-associated protein-2 (MAP-2), glial marker S100b and demyelination marker myelin basic protein (MBP) [37][38][39]. The table in the appendix describes the Lower (LLoD) and Upper (ULoD) limits of detection for each of the seven biomarkers.…”

Section: Biomarker Analysismentioning

confidence: 99%

Biomarkers Improve Clinical Outcome Predictors of Mortality Following Non-Penetrating Severe Traumatic Brain Injury

et al. 2014

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Section: Biomarker Analysismentioning

confidence: 99%

Biomarkers Improve Clinical Outcome Predictors of Mortality Following Non-Penetrating Severe Traumatic Brain Injury

et al. 2014

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“…There have been a number of biomarkers assessed for TBI [56, 57]. The most extensively studied among these include glial protein S-100 beta (β) [58–60], neuron-specific enolase (NSE) [61–64], and myelin basic protein (MBP) [65–67].…”

Section: Future Researchmentioning

confidence: 99%

Mild Traumatic Brain Injury Among the Geriatric Population

Papa

Mendes

Braga

2012

Curr Tran Geriatr Gerontol Rep

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Mild traumatic brain injury (TBI) is an unfortunately common occurrence in the elderly. With the growing population of older adults in the United States and globally, strategies that reduce the risk of becoming injured need to be developed, and diagnostic tools and treatments that may benefit this group need to be explored. Particular attention needs to be given to polypharmacy, drug interactions, the use of anticoagulants, safety issues in the living environment, elder abuse, and alcohol consumption. Low-mechanism falls should prompt health care providers to consider the possibility of head injury in elderly patients. Early and tailored management of our seniors following a mild TBI can provide them with the best possible quality of life. This review will discuss the current literature on mild TBI in the older adult, address gaps in research, and discuss the implications for future care of the older TBI patient.

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“…13 Important properties that should be considered when evaluating a biomarker for clinical application include: 1) demonstrate a high sensitivity and specificity for brain injury, 2) stratify patients by severity of injury, 3) have a rapid appearance in accessible biological fluid, 4) provide information about injury mechanisms, 5) have well-defined biokinetc properties, 6) monitor progress of disease and response to treatment, and 7) predict functional outcome. 13,14 …”

Section: Introductionmentioning

confidence: 99%

Performance of Glial Fibrillary Acidic Protein in Detecting Traumatic Intracranial Lesions on Computed Tomography in Children and Youth With Mild Head Trauma

Papa

Zonfrillo

Ramirez

et al. 2015

Academic Emergency Medicine

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Objectives This study examined the performance of serum glial fibrillary acidic protein (GFAP) in detecting traumatic intracranial lesions on computed tomography (CT) scan in children and youth with mild and moderate traumatic brain injury (TBI), and assessed its performance in trauma control patients without head trauma. Methods This prospective cohort study enrolled children and youth presenting to three Level I trauma centers following blunt head trauma with Glasgow Coma Scale (GCS) scores of 9 to 15, as well as trauma control patients with GCS scores of 15 who did not have blunt head trauma. The primary outcome measure was the presence of intracranial lesions on initial CT scan. Blood samples were obtained in all patients within six hours of injury and measured by ELISA for GFAP (ng/ml). Results A total of 257 children and youth were enrolled in the study and had serum samples drawn within 6 hours of injury for analysis: 197 had blunt head trauma and 60 were trauma controls. CT scan of the head was performed in 152 patients and traumatic intracranial lesions on CT scan were evident in 18 (11%), all of whom had GCS scores of 13 to 15. When serum levels of GFAP were compared in children and youth with traumatic intracranial lesions on CT scan to those without CT lesions, median GFAP levels were significantly higher in those with intracranial lesions (1.01, IQR 0.59 to 1.48) than those without lesions (0.18, IQR 0.06 to 0.47). The area under the receiver operating characteristic (ROC) curve (AUC) for GFAP in detecting children and youth with traumatic intracranial lesions on CT was 0.82 (95% CI = 0.71 to 0.93). In those presenting with GCS scores of 15, the AUC for detecting lesions was 0.80 (95% CI = 0.68 to 0.92). Similarly, in children under five years old the AUC was 0.83 (95% CI = 0.56 to 1.00). Performance for detecting intracranial lesions at a GFAP cutoff level of 0.15 ng/ml yielded a sensitivity of 94%, a specificity of 47%, and a negative predictive value of 98%. Conclusions In children and youth of all ages, GFAP measured within 6 hours of injury was associated with traumatic intracranial lesions on CT and with severity of TBI. Further study is required to validate these findings before clinical application.

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Exploring the Role of Biomarkers for the Diagnosis and Management of Traumatic Brain Injury Patients

Cited by 15 publications

References 143 publications

Biomarkers Improve Clinical Outcome Predictors of Mortality Following Non-Penetrating Severe Traumatic Brain Injury

Biomarkers Improve Clinical Outcome Predictors of Mortality Following Non-Penetrating Severe Traumatic Brain Injury

Mild Traumatic Brain Injury Among the Geriatric Population

Performance of Glial Fibrillary Acidic Protein in Detecting Traumatic Intracranial Lesions on Computed Tomography in Children and Youth With Mild Head Trauma

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