Blood Biomarkers for Traumatic Brain Injury: A Quantitative Assessment of Diagnostic and Prognostic Accuracy
Blood biomarkers have been explored for their potential to provide objective measures in the assessment of traumatic brain injury (TBI). However, it is not clear which biomarkers are best for diagnosis and prognosis in different severities of TBI. Here, we compare existing studies on the discriminat...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00446/full |
| _version_ | 1818177392592551936 |
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| author | Zoe S. Gan Sherman C. Stein Randel Swanson Randel Swanson Randel Swanson Randel Swanson Shaobo Guan Lizette Garcia Devanshi Mehta Douglas H. Smith |
| author_facet | Zoe S. Gan Sherman C. Stein Randel Swanson Randel Swanson Randel Swanson Randel Swanson Shaobo Guan Lizette Garcia Devanshi Mehta Douglas H. Smith |
| author_sort | Zoe S. Gan |
| collection | DOAJ |
| description | Blood biomarkers have been explored for their potential to provide objective measures in the assessment of traumatic brain injury (TBI). However, it is not clear which biomarkers are best for diagnosis and prognosis in different severities of TBI. Here, we compare existing studies on the discriminative abilities of serum biomarkers for four commonly studied clinical situations: detecting concussion, predicting intracranial damage after mild TBI (mTBI), predicting delayed recovery after mTBI, and predicting adverse outcome after severe TBI (sTBI). We conducted a literature search of publications on biomarkers in TBI published up until July 2018. Operating characteristics were pooled for each biomarker for comparison. For detecting concussion, 4 biomarker panels and creatine kinase B type had excellent discriminative ability. For detecting intracranial injury and the need for a head CT scan after mTBI, 2 biomarker panels, and hyperphosphorylated tau had excellent operating characteristics. For predicting delayed recovery after mTBI, top candidates included calpain-derived αII-spectrin N-terminal fragment, tau A, neurofilament light, and ghrelin. For predicting adverse outcome following sTBI, no biomarker had excellent performance, but several had good performance, including markers of coagulation and inflammation, structural proteins in the brain, and proteins involved in homeostasis. The highest-performing biomarkers in each of these categories may provide insight into the pathophysiologies underlying mild and severe TBI. With further study, these biomarkers have the potential to be used alongside clinical and radiological data to improve TBI diagnostics, prognostics, and evidence-based medical management. |
| first_indexed | 2024-12-11T20:31:21Z |
| format | Article |
| id | doaj.art-321ae1822ab14374b5a236d7ea70221e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T20:31:21Z |
| publishDate | 2019-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-321ae1822ab14374b5a236d7ea70221e2022-12-22T00:51:49ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-04-011010.3389/fneur.2019.00446452760Blood Biomarkers for Traumatic Brain Injury: A Quantitative Assessment of Diagnostic and Prognostic AccuracyZoe S. Gan0Sherman C. Stein1Randel Swanson2Randel Swanson3Randel Swanson4Randel Swanson5Shaobo Guan6Lizette Garcia7Devanshi Mehta8Douglas H. Smith9University of North Carolina School of Medicine, Chapel Hill, NC, United StatesDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesRehabilitation Medicine Service, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United StatesCenter for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United StatesDepartment of Neurosurgery, Perelman School of Medicine, Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Neurosurgery, Perelman School of Medicine, Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA, United StatesBlood biomarkers have been explored for their potential to provide objective measures in the assessment of traumatic brain injury (TBI). However, it is not clear which biomarkers are best for diagnosis and prognosis in different severities of TBI. Here, we compare existing studies on the discriminative abilities of serum biomarkers for four commonly studied clinical situations: detecting concussion, predicting intracranial damage after mild TBI (mTBI), predicting delayed recovery after mTBI, and predicting adverse outcome after severe TBI (sTBI). We conducted a literature search of publications on biomarkers in TBI published up until July 2018. Operating characteristics were pooled for each biomarker for comparison. For detecting concussion, 4 biomarker panels and creatine kinase B type had excellent discriminative ability. For detecting intracranial injury and the need for a head CT scan after mTBI, 2 biomarker panels, and hyperphosphorylated tau had excellent operating characteristics. For predicting delayed recovery after mTBI, top candidates included calpain-derived αII-spectrin N-terminal fragment, tau A, neurofilament light, and ghrelin. For predicting adverse outcome following sTBI, no biomarker had excellent performance, but several had good performance, including markers of coagulation and inflammation, structural proteins in the brain, and proteins involved in homeostasis. The highest-performing biomarkers in each of these categories may provide insight into the pathophysiologies underlying mild and severe TBI. With further study, these biomarkers have the potential to be used alongside clinical and radiological data to improve TBI diagnostics, prognostics, and evidence-based medical management.https://www.frontiersin.org/article/10.3389/fneur.2019.00446/fulltraumatic brain injuryTBIconcussiondiagnosisprognosisbiomarker |
| spellingShingle | Zoe S. Gan Sherman C. Stein Randel Swanson Randel Swanson Randel Swanson Randel Swanson Shaobo Guan Lizette Garcia Devanshi Mehta Douglas H. Smith Blood Biomarkers for Traumatic Brain Injury: A Quantitative Assessment of Diagnostic and Prognostic Accuracy Frontiers in Neurology traumatic brain injury TBI concussion diagnosis prognosis biomarker |
| title | Blood Biomarkers for Traumatic Brain Injury: A Quantitative Assessment of Diagnostic and Prognostic Accuracy |
| title_full | Blood Biomarkers for Traumatic Brain Injury: A Quantitative Assessment of Diagnostic and Prognostic Accuracy |
| title_fullStr | Blood Biomarkers for Traumatic Brain Injury: A Quantitative Assessment of Diagnostic and Prognostic Accuracy |
| title_full_unstemmed | Blood Biomarkers for Traumatic Brain Injury: A Quantitative Assessment of Diagnostic and Prognostic Accuracy |
| title_short | Blood Biomarkers for Traumatic Brain Injury: A Quantitative Assessment of Diagnostic and Prognostic Accuracy |
| title_sort | blood biomarkers for traumatic brain injury a quantitative assessment of diagnostic and prognostic accuracy |
| topic | traumatic brain injury TBI concussion diagnosis prognosis biomarker |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00446/full |
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