Immediate S-100B and Neuron-Specific Enolase Plasma Measurements for Rapid Evaluation of Primary Brain Damage in Alcohol-Intoxicated, Minor Head-Injured Patients

Abstract

The neuroproteins S-100B and neuron-specific enolase (NSE) released into the circulation are suggested to be reliable markers for primary brain damage. However, safe identification of relevant post-traumatic complications after minor head injury (MHI) is often hampered by acute intoxication of the patients. The objective of this study was to determine the diagnostic validity of immediate plasma measurements of S-100B and NSE in comparison with neurological examinations and cerebral computed tomography (CCT) findings in alcohol-intoxicated MHI patients. One hundered thrity-nine MHI individuals were enrolled in this prospective study during Munich's Oktoberfest 2000. Plasma levels of S-100B and NSE as well as serum alcohol and glucose values were determined by fully automated assays immediately after admission. The results were compared with Glasgow Coma Scale score, a brief neurological examination, and the CCT findings. Without being influenced by alcohol, median S-100B levels of the CCT+ group were significantly increased compared with those of the CCT- group (P < 0.001). NSE, alcohol, and glucose levels showed no significant group differences. As calculated by the ROC analysis, a cutoff value of 0.21 ng/mL with an area under the curve of 0.864 clearly differentiates between CCT+ and CCT- patients at a sensitivity of 100%, a specificity of 50.0%, and a positive likelihood ratio of 2.0. Although acute alcohol intoxication did not confound plasma measurements of S-100B and NSE, only S-100B levels below the cutoff level of 0.21 ng/mL seem to indicate absence of primary brain damage. Thus, in addition to routine neurological examinations, S-100B measurements immediately after admission might help to reduce CCT scans in alcohol-intoxicated patients early after MHI.

Predictive value of neuromarkers supported by a set of clinical criteria in patients with mild traumatic brain injury: S100B protein and neuron-specific enolase on trial

“…4,12,17 In contrast, our results showed no significant correlation among alcohol, S100B, and NSE levels. Patient age was not a significant risk factor in our study.…”

“…5,17,18,24 On the other hand, some studies question the prognostic value in clinical routine: A study conducted in professional soccer players showed a confounding effect of high-intensity exercise on S100B levels in serum. 28 Another study featuring 44 patients with severe head injury found no significant correlation between contusion volume and NSE levels.…”

Choline Redistribution during Adaptation to Choline Deprivation

“…Plasma S100␤ Protein Assay-S100␤ is a protein in brain and, when found in the plasma, is a marker of brain damage (17,18). Sandwich enzyme-linked immunosorbent assay was performed for measurement of the level of S100␤ protein in 20 l of plasma using rabbit polyclonal anti-S100␤ protein antibodies (Santa Cruz Biotechnology).…”

“…Choline Deprivation-The brain protein S100␤, when found in the plasma, is a marker of brain damage (17,18). S100␤ was not detected in the plasma of CS-and CD-Pemt Ϫ/Ϫ mice or in CS-and CD-Mdr2…”

Minor Head Trauma in Soccer and Serum Levels of S100b

“…The serum levels of S100B increases rapidly after a traumatic brain injury and some studies have reported a 10-15 fold increase above baseline levels, followed by a significant decrease the next 4-6 hours due to its short half-life (10,27,28,38,48,63). An increased level of S100B after minor head traumas has been reported to be associated with pathological findings on CT scans (9,36), prolonged in-hospital stays (38), prolonged absence from work (59), post concussive complaints (14,50) and disability one year after the incident (53). In addition, S100B is associated with the Glasgow Coma Scale score at admission and the outcome after more severe head injury (46,64).…”