Neuron-specific enolase and S100BB as outcome predictors in severe diffuse axonal injury

Yousefzadeh-Chabok, Shahrokh; Moghadam, Anoush Dehnadi; Saneei, Zahra; Amlashi, Fatemeh Ghazanfari; Leili, Ehsan Kazemnezhad; Mohtasham-Amiri, Zahra

doi:10.1097/ta.0b013e318246887e

Cited by 74 publications

(50 citation statements)

References 23 publications

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“…Studies (3, 5, 11, 18, 27, 32) show that the frequency of DAI is higher in severe TBI victims who have indirect signs of injury on CT, such as intraventricular hemorrhage and subarachnoid hemorrhage, rather than a normal CT scan. In this study, for the analyses of association with the consequences of trauma, patients with normal CT scans were analyzed separately from those with signs suggestive of DAI, and the presence of these signs was more frequent among patients who progressed to death.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Axonal Injury: Epidemiology, Outcome and Associated Risk Factors

et al. 2016

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Diffuse axonal injury (DAI), a type of traumatic injury, is known for its severe consequences. However, there are few studies describing the outcomes of DAI and the risk factors associated with it. This study aimed to describe the outcome for patients with a primary diagnosis of DAI 6 months after trauma and to identify sociodemographic and clinical factors associated with mortality and dependence at this time point. Seventy-eight patients with DAI were recruited from July 2013 to February 2014 in a prospective cohort study. Patient outcome was analyzed using the Extended Glasgow Outcome Scale (GOS-E) within 6 months of the traumatic injury. The mean Injury Severity Score was 35.0 (SD = 11.9), and the mean New Injury Severity Score (NISS) was 46.2 (SD = 15.9). Mild DAI was observed in 44.9% of the patients and severe DAI in 35.9%. Six months after trauma, 30.8% of the patients had died, and 45.1% had shown full recovery according to the GOS-E. In the logistic regression model, the severity variables – DAI with hypoxia, as measured by peripheral oxygen saturation, and hypotension with NISS value – had a statistically significant association with patient mortality; on the other hand, severity of DAI and length of hospital stay were the only significant predictors for dependence. Therefore, severity of DAI emerged as a risk factor for both mortality and dependence.

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Section: Discussionmentioning

confidence: 99%

Diffuse Axonal Injury: Epidemiology, Outcome and Associated Risk Factors

et al. 2016

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“…Accordingly, NSE has excellent theoretical potential as a long-term prognostic biomarker and therapeutic indicator in neurological intensive care [12]–[13]. Several studies have suggested increased NSE concentrations in blood following TBI, indicating a potential clinical role as a biomarker of this injury [14]–[17]. However, its association with outcome remains unclear.…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of Serum Neuron-Specific Enolase in Traumatic Brain Injury: Systematic Review and Meta-Analysis

et al. 2014

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BackgroundSeveral studies have suggested that neuron-specific enolase (NSE) in serum may be a biomarker of traumatic brain injury. However, whether serum NSE levels correlate with outcomes remains unclear. The purpose of this review was to evaluate the prognostic value of serum NSE protein after traumatic brain injury.MethodsPubMed and Embase were searched for relevant studies published up to October 2013. Full-text publications on the relationship of NSE to TBI were included if the studies concerned patients with closed head injury, NSE levels in serum after injury, and Glasgow Outcome Scale (GOS) or Extended GOS (GOSE) scores or mortality. Study design, inclusion criteria, assay, blood sample collection time, NSE cutoff, sensitivity and specificity of NSE for mortality prediction (if sufficient information was provided to calculate these values), and main outcomes were recorded.ResultsSixteen studies were eligible for the current meta-analysis. In the six studies comparing NSE concentrations between TBI patients who died and those who survived, NSE concentrations correlated with mortality (M.D. 0.28, 95% confidence interval (CI), 0.21 to 0.34; I2 55%). In the eight studies evaluating GOS or GOSE, patients with unfavorable outcomes had significantly higher NSE concentrations than those with favorable outcomes (M.D. 0.24, 95% CI, 0.17 to 0.31; I2 64%). From the studies providing sufficient data, the pooled sensitivity and specificity for mortality were 0.79 and 0.50, and 0.72 and 0.66 for unfavorable neurological prognosis, respectively. The areas under the SROC curve (AUC) of NSE concentrations were 0.73 (95% CI, 0.66–0.80) for unfavorable outcome and 0.76 (95% CI, 0.62–0.90) for mortality.ConclusionsMortality and unfavorable outcome were significantly associated with greater NSE concentrations. In addition, NSE has moderate discriminatory ability to predict mortality and neurological outcome in TBI patients. The optimal discrimination cutoff values and optimal sampling time remain uncertain because of significant variations between studies.

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“…Obviously, a contusion or other lesion, even if small in size, in a more critical part of the cerebral network would more severely affect brain connectivity and presumably not be accurately represented by the S100B level. In patients with only diffuse cerebral injuries, lower levels of S100B are usually present (Chabok et al, 2012). However, we included S100B levels sampled 12 h after injury, as earlier samples are more heavily influenced by extracranial trauma (Thelin et al, 2015) and we could not detect any correlation between age, gender and multitrauma with our levels of S100B (data not shown), hence proving its role as a marker of intracranial injury.…”

Section: Discussionmentioning

confidence: 99%

Functional resting-state fMRI connectivity correlates with serum levels of the S100B protein in the acute phase of traumatic brain injury

Thompson

Thelin

Lilja

et al. 2016

NeuroImage: Clinical

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The S100B protein is an intra-cellular calcium-binding protein that mainly resides in astrocytes in the central nervous system. The serum level of S100B is used as biomarker for the severity of brain damage in traumatic brain injury (TBI) patients. In this study we investigated the relationship between intrinsic resting-state brain connectivity, measured 1–22 days (mean 8 days) after trauma, and serum levels of S100B in a patient cohort with mild-to-severe TBI in need of neuro-intensive care in the acute phase. In line with previous investigations, our results show that the peak level of S100B acquired during the acute phase of TBI was negatively correlated with behavioral measures (Glasgow Outcome Score, GOS) of functional outcome assessed 6 to 12 months post injury. Using a multi-variate pattern analysis-informed seed-based correlation analysis, we show that the strength of resting-state brain connectivity in multiple resting-state networks was negatively correlated with the peak of serum levels of S100B. A negative correspondence between S100B peak levels recorded 12–36 h after trauma and intrinsic connectivity was found for brain regions located in the default mode, fronto-parietal, visual and motor resting-state networks. Our results suggest that resting-state brain connectivity measures acquired during the acute phase of TBI is concordant with results obtained from molecular biomarkers and that it may hold a capacity to predict long-term cognitive outcome in TBI patients.

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Neuron-specific enolase and S100BB as outcome predictors in severe diffuse axonal injury

Abstract: Prognostic study, level III.

Cited by 74 publications

References 23 publications

Diffuse Axonal Injury: Epidemiology, Outcome and Associated Risk Factors

Diffuse Axonal Injury: Epidemiology, Outcome and Associated Risk Factors

The Prognostic Value of Serum Neuron-Specific Enolase in Traumatic Brain Injury: Systematic Review and Meta-Analysis

Functional resting-state fMRI connectivity correlates with serum levels of the S100B protein in the acute phase of traumatic brain injury

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