Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patients
Although mild traumatic brain injury (mTBI), or concussion, is not typically associated with abnormalities on computed tomography (CT), it nevertheless causes persistent cognitive dysfunction for many patients. Consequently, new prognostic methods for mTBI are needed to identify at-risk cases, espe...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2013-11-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fneur.2013.00190/full |
| _version_ | 1819211815276511232 |
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| author | Robert eSiman Nicholas eGiovannone Gerri eHanten Elisabeth eWilde Stephen eMcCauley Jill eHunter Xiaoqi eLi Harvey S Levin Douglas eSmith |
| author_facet | Robert eSiman Nicholas eGiovannone Gerri eHanten Elisabeth eWilde Stephen eMcCauley Jill eHunter Xiaoqi eLi Harvey S Levin Douglas eSmith |
| author_sort | Robert eSiman |
| collection | DOAJ |
| description | Although mild traumatic brain injury (mTBI), or concussion, is not typically associated with abnormalities on computed tomography (CT), it nevertheless causes persistent cognitive dysfunction for many patients. Consequently, new prognostic methods for mTBI are needed to identify at-risk cases, especially at an early and potentially treatable stage. Here, we quantified plasma levels of the neurodegeneration biomarker calpain-cleaved alphaII-spectrin N-terminal fragment (SNTF) from 38 participants with CT-negative mTBI, orthopedic injury (OI) and normal uninjured controls (age range 12-30 years), and compared them with findings from diffusion tensor magnetic resonance imaging (DTI) and long-term cognitive assessment. SNTF levels were at least twice the lower limit of detection in 7 of 17 mTBI cases and in 3 of 13 OI cases, but in none of the uninjured controls. An elevation in plasma SNTF corresponded with significant differences in fractional anisotropy and the apparent diffusion coefficient in the corpus callosum and uncinate fasciculus measured by DTI. Furthermore, increased plasma SNTF on the day of injury correlated significantly with cognitive impairment that persisted for at least 3 months, both across all study participants and also among the mTBI cases by themselves. The elevation in plasma SNTF in the subset of OI cases, accompanied by corresponding white matter and cognitive abnormalities, raises the possibility of identifying undiagnosed cases of mTBI. These data suggest that the blood level of SNTF on the day of a CT-negative mTBI may identify a subset of patients at risk of white matter damage and persistent disability. SNTF could have prognostic and diagnostic utilities in the assessment and treatment of mTBI. |
| first_indexed | 2024-12-23T06:33:04Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-23T06:33:04Z |
| publishDate | 2013-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-4578fa364d23455eb3686e15fa0af3df2022-12-21T17:56:52ZengFrontiers Media S.A.Frontiers in Neurology1664-22952013-11-01410.3389/fneur.2013.0019071158Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patientsRobert eSiman0Nicholas eGiovannone1Gerri eHanten2Elisabeth eWilde3Stephen eMcCauley4Jill eHunter5Xiaoqi eLi6Harvey S Levin7Douglas eSmith8University of Pennsylvania School of MedicineUniversity of Pennsylvania School of MedicineBaylor College of MedicineBaylor College of MedicineBaylor College of MedicineBaylor College of MedicineBaylor College of MedicineBaylor College of MedicineUniversity of Pennsylvania School of MedicineAlthough mild traumatic brain injury (mTBI), or concussion, is not typically associated with abnormalities on computed tomography (CT), it nevertheless causes persistent cognitive dysfunction for many patients. Consequently, new prognostic methods for mTBI are needed to identify at-risk cases, especially at an early and potentially treatable stage. Here, we quantified plasma levels of the neurodegeneration biomarker calpain-cleaved alphaII-spectrin N-terminal fragment (SNTF) from 38 participants with CT-negative mTBI, orthopedic injury (OI) and normal uninjured controls (age range 12-30 years), and compared them with findings from diffusion tensor magnetic resonance imaging (DTI) and long-term cognitive assessment. SNTF levels were at least twice the lower limit of detection in 7 of 17 mTBI cases and in 3 of 13 OI cases, but in none of the uninjured controls. An elevation in plasma SNTF corresponded with significant differences in fractional anisotropy and the apparent diffusion coefficient in the corpus callosum and uncinate fasciculus measured by DTI. Furthermore, increased plasma SNTF on the day of injury correlated significantly with cognitive impairment that persisted for at least 3 months, both across all study participants and also among the mTBI cases by themselves. The elevation in plasma SNTF in the subset of OI cases, accompanied by corresponding white matter and cognitive abnormalities, raises the possibility of identifying undiagnosed cases of mTBI. These data suggest that the blood level of SNTF on the day of a CT-negative mTBI may identify a subset of patients at risk of white matter damage and persistent disability. SNTF could have prognostic and diagnostic utilities in the assessment and treatment of mTBI.http://journal.frontiersin.org/Journal/10.3389/fneur.2013.00190/fullCalpainDiffuse Axonal InjurySpectrinDTIconcussioncognitive impairment |
| spellingShingle | Robert eSiman Nicholas eGiovannone Gerri eHanten Elisabeth eWilde Stephen eMcCauley Jill eHunter Xiaoqi eLi Harvey S Levin Douglas eSmith Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patients Frontiers in Neurology Calpain Diffuse Axonal Injury Spectrin DTI concussion cognitive impairment |
| title | Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patients |
| title_full | Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patients |
| title_fullStr | Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patients |
| title_full_unstemmed | Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patients |
| title_short | Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patients |
| title_sort | evidence that the blood biomarker sntf predicts brain imaging changes and persistent cognitive dysfunction in mild tbi patients |
| topic | Calpain Diffuse Axonal Injury Spectrin DTI concussion cognitive impairment |
| url | http://journal.frontiersin.org/Journal/10.3389/fneur.2013.00190/full |
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