Predictive Biomarkers of Recovery in Traumatic Brain Injury

Giacoppo, Sabrina; Bramantı, Placido; Barresi, Marina; Celi, Debora; Cuzzola, Valeria Foti; Palella, Eleonora; Marıno, Silvia

doi:10.1007/s12028-012-9707-z

Cited by 45 publications

(42 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although previous narrative reviews have illustrated the potential of NSE concentrations for predicting outcome after traumatic brain injury [40]–[41], none of these used systematic review and meta-analysis methods. Extracerebral sources of NSE could lead to overestimation of the severity of the brain lesion in the early phase after TBI in patients with multiple injuries [40].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

View full text Add to dashboard Cite

show abstract

“…This is followed by the subsequent release of GFAP-BDPs in substantive quantity through a compromised brain-blood barrier into the circulation. 24,[27][28][29] This combination allows GFAP and GFAP-BDPs to become accessible to and recognized by the immune cells as nonself-proteins, triggering autoantibody response in those individuals.…”

Section: Introductionmentioning

confidence: 99%

Plasma Anti-Glial Fibrillary Acidic Protein Autoantibody Levels during the Acute and Chronic Phases of Traumatic Brain Injury: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot Study

Wang

Yang

Yue

et al. 2016

Journal of Neurotrauma

View full text Add to dashboard Cite

We described recently a subacute serum autoantibody response toward glial fibrillary acidic protein (GFAP) and its breakdown products 5-10 days after severe traumatic brain injury (TBI). Here, we expanded our anti-GFAP autoantibody (AutoAb[GFAP]) investigation to the multicenter observational study Transforming Research and Clinical Knowledge in TBI Pilot (TRACK-TBI Pilot) to cover the full spectrum of TBI (Glasgow Coma Scale 3-15) by using acute (<24 h) plasma samples from 196 patients with acute TBI admitted to three Level I trauma centers, and a second cohort of 21 participants with chronic TBI admitted to inpatient TBI rehabilitation. We find that acute patients self-reporting previous TBI with loss of consciousness (LOC) (n = 43) had higher day 1 AutoAb[GFAP] (mean -standard error: 9.11 -1.42; n = 43) than healthy controls (2.90 -0.92; n = 16; p = 0.032) and acute patients reporting no previous TBI (2.97 -0.37; n = 106; p < 0.001), but not acute patients reporting previous TBI without LOC (8.01 -1.80; n = 47; p = 0.906). These data suggest that while exposure to TBI may trigger the AutoAb[GFAP] response, circulating antibodies are elevated specifically in acute TBI patients with a history of TBI. AutoAb[GFAP] levels for participants with chronic TBI (average post-TBI time 176 days or 6.21 months) were also significantly higher (15.08 -2.82; n = 21) than healthy controls ( p < 0.001). These data suggest a persistent upregulation of the autoimmune response to specific brain antigen(s) in the subacute to chronic phase after TBI, as well as after repeated TBI insults. Hence, AutoAb[GFAP] may be a sensitive assay to study the dynamic interactions between postinjury brain and patient-specific autoimmune responses across acute and chronic settings after TBI.

show abstract

“…Serum levels are initially elevated in acute trauma but return to baseline normal levels quickly. Serum levels of CKBB have been found elevated in various brain injury settings, including after cardiac arrest or subarachnoid hemorrhage [53, 54]. Coplin et al found the level of CKBB predicted unfavorable outcomes after subarachnoid hemorrhage [53].…”

Section: Discussionmentioning

confidence: 99%

A blood-based biomarker panel to risk-stratify mild traumatic brain injury

et al. 2017

View full text Add to dashboard Cite

Mild traumatic brain injury (TBI) accounts for the vast majority of the nearly two million brain injuries suffered in the United States each year. Mild TBI is commonly classified as complicated (radiographic evidence of intracranial injury) or uncomplicated (radiographically negative). Such a distinction is important because it helps to determine the need for further neuroimaging, potential admission, or neurosurgical intervention. Unfortunately, imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) are costly and not without some risk. The purpose of this study was to screen 87 serum biomarkers to identify a select panel of biomarkers that would predict the presence of intracranial injury as determined by initial brain CT. Serum was collected from 110 patients who sustained a mild TBI within 24 hours of blood draw. Two models were created. In the broad inclusive model, 72kDa type IV collagenase (MMP-2), C-reactive protein (CRP), creatine kinase B type (CKBB), fatty acid binding protein—heart (hFABP), granulocyte-macrophage colony-stimulating factor (GM-CSF) and malondialdehyde modified low density lipoprotein (MDA-LDL) significantly predicted injury visualized on CT, yielding an overall c-statistic of 0.975 and a negative predictive value (NPV) of 98.6. In the parsimonious model, MMP-2, CRP, and CKBB type significantly predicted injury visualized on CT, yielding an overall c-statistic of 0.964 and a negative predictive value (NPV) of 97.2. These results suggest that a serum based biomarker panel can accurately differentiate patients with complicated mild TBI from those with uncomplicated mild TBI. Such a panel could be useful to guide early triage decisions, including the need for further evaluation or admission, especially in those environments in which resources are limited.

show abstract

Predictive Biomarkers of Recovery in Traumatic Brain Injury

Cited by 45 publications

References 67 publications

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

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

Plasma Anti-Glial Fibrillary Acidic Protein Autoantibody Levels during the Acute and Chronic Phases of Traumatic Brain Injury: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot Study

A blood-based biomarker panel to risk-stratify mild traumatic brain injury

Contact Info

Product

Resources

About