Outcome prediction in traumatic brain injury: comparison of neurological status, CT findings, and blood levels of S100B and GFAP

Wiesmann, Martin; Steinmeier, Elke; Magerkurth, Olaf; Linn, Jennifer; Gottmann, D.; Mißler, U.

doi:10.1111/j.1600-0404.2009.01196.x

Cited by 73 publications

(45 citation statements)

References 36 publications

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“…Previous studies have focused primarily on three brain-specific markers-neuronspecific enolase (NSE), S100B, and myelin-basic protein (MBP)-and have consistently shown an association between higher concentrations of serum biomarkers and poorer outcome after TBI (Berger 2006Guzel et al, 2008;Vos et al, 2010;Wiesmann et al, 2010;Yamazaki et al, 1995). Each of these markers has limitations.…”

Section: Introductionmentioning

confidence: 99%

Serum Concentrations of Ubiquitin C-Terminal Hydrolase-L1 and αII-Spectrin Breakdown Product 145 kDa Correlate with Outcome after Pediatric TBI

Berger

Hayes

Richichi³

et al. 2012

Journal of Neurotrauma

131

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Predicting outcome after pediatric traumatic brain injury (TBI) is important for providing information to families and prescribing rehabilitation services. Previously published studies evaluating the ability of serum biomarkers to predict outcome after pediatric TBI have focused on three markers: neuron-specific enolase (NSE), S100B, and myelin-basic protein (MBP), all of which have important limitations. The study objectives were to measure serum concentrations of two novel serum biomarkers, ubiquitin C-terminal hydrolase (UCH-L1) and aII-spectrin breakdown product 145 kDa (SBDP145), in children with TBI and healthy controls and to assess the ability of these markers to predict outcome as assessed by a dichotomous Glasgow Outcome Scale (GOS) score. We also sought to compare the predictive ability of UCH-L1 and SBDP145 to that of the clinical gold standard, the Glasgow Coma Scale (GCS) score, and to that of the well-accepted biomarkers NSE, S100B, and MBP. Serum UCH-L1 and SBDP145 concentrations were significantly greater in subjects than in controls. The increase in UCH-L1 and SBDP145 was exclusively seen in subjects with moderate and severe TBI; there was no increase after mild TBI. Both markers had a significant negative partial correlation with the GCS after controlling for age. Both UCH-L1 and SBDP145 were correlated with GOS, and this correlation was stronger than the correlations with NSE, S100B, or MBP. These results suggest that these two markers may be useful in assessing outcome after moderate and severe pediatric TBI.

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Section: Introductionmentioning

confidence: 99%

Serum Concentrations of Ubiquitin C-Terminal Hydrolase-L1 and αII-Spectrin Breakdown Product 145 kDa Correlate with Outcome after Pediatric TBI

Berger

Hayes

Richichi³

et al. 2012

Journal of Neurotrauma

131

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“…However, when astrocytes are damaged, GFAP is released into the cerebrospinal fluid (CSF) as soluble fragments [6,8]. In humans, increased levels of GFAP in the CSF and blood have been reported with various neural diseases, for example, systemic lupus erythematosus, multiple sclerosis, Alzheimer's disease, subarachnoid hemorrhage and traumatic brain injury [3,16,17]. We postulated that GFAP may be released to peripheral blood in progressive myelomalacia following neural damage.…”

mentioning

confidence: 99%

Serum Glial Fibrillary Acidic Protein as a Diagnostic Biomarker in Dogs with Progressive Myelomalacia

Sato

Shimamura

Mashita

et al. 2013

The Journal of Veterinary Medical Science

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ABSTRACT. In humans, increased levels of GFAP in the CSF and blood have been reported with various neural diseases. However, there has been no study describing the usefulness of GFAP in the blood for disease of the spinal cord in dogs. The aim of this study was to describe the utility of GFAP in serum for a diagnosis of progressive myelomalacia. Fifty-six dogs with acute thoracolumbar IVDD diagnosed by computed tomography with myelography or MRI were included. Serum specimens were collected at initial presentation from all cases and at follow-up examinations from some cases. Serum samples were assayed for GFAP concentrations using a commercially available GFAP ELISA Kit. Progressive myelomalacia was the final diagnosis in 8/51 cases (15.6%). Eight dogs had clinical signs suggestive of progressive myelomalacia, of which 6 were positive and 2 were negative by GFAP. Seven dogs had a detectable level of serum GFAP, of which 6 had the onset of progressive myelomalacia. The sensitivity and specificity of the GFAP to progressive myelomalacia were 75% and 97.7%, respectively. The results suggest the utility of GFAP in serum in the diagnosis of progressive myelomalacia.

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“…Other studies show that serum levels of S100 beta protein and neuron-specific enolase, markers of glial and neuronal damage, respectively, correlate with TBI severity [43][44][45]. Thus, measuring the S100 beta protein could be useful in evaluating the severity of TBI and determining the long-term prognosis [46].…”

Section: Research Innovations: Biomarkersmentioning

confidence: 99%

End Points of Traumatic Brain Injury Resuscitation

Wesson

Ferrada

2015

Curr Trauma Rep

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Severe traumatic brain injury (TBI) is an insult severe enough to cause an acute and persistent loss of consciousness with a significant risk of death or disability. Worldwide, it is a leading cause of death, especially for younger people less than 50 years of age. Over the last two decades, we have made significant progress in our understanding of the pathophysiology of TBI. This however has not resulted in substantial improvements in outcome, as the incidence of TBI continues to increase and mortality rates remain relatively unchanged. To better understand the long-term outcome and end points in TBI resuscitation, tools to predict a patient's prognosis becomes essential. In this review, we discuss the role of clinical assessment, as such the Glasgow Coma Scale and the Full Outline of UnResponsiveness Score, neuroimaging, including computed tomography (CT) and MRI, and current research innovations, such as the biomarkers, to predict TBI outcomes. Additionally, we describe the clinical implications of using prognostic models, such as the International Mission on Prognosis and Analysis of Clinical Trials in TBI (IMPACT) database models and the Corticosteroid Randomization after Significant Head Injury (CRASH) trial data models to calculate TBI outcome.

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Outcome prediction in traumatic brain injury: comparison of neurological status, CT findings, and blood levels of S100B and GFAP

Abstract: Blood levels of S100B and GFAP indicate the severity of brain damage and are correlated with neurological prognosis after trauma. Both methods can yield additional prognostic information if combined with clinical and CCT findings.

Cited by 73 publications

References 36 publications

Serum Concentrations of Ubiquitin C-Terminal Hydrolase-L1 and αII-Spectrin Breakdown Product 145 kDa Correlate with Outcome after Pediatric TBI

Serum Concentrations of Ubiquitin C-Terminal Hydrolase-L1 and αII-Spectrin Breakdown Product 145 kDa Correlate with Outcome after Pediatric TBI

Serum Glial Fibrillary Acidic Protein as a Diagnostic Biomarker in Dogs with Progressive Myelomalacia

End Points of Traumatic Brain Injury Resuscitation

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