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Chronic immunosuppr...
Chronic immunosuppression across 12 months and high ability of acute and subacute CNS-injury biomarker concentrations to identify individuals with complicated mTBI on acute CT and MRI.
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Clarke, Gerard Janez Brett (författare)
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Follestad, Turid (författare)
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Skandsen, Toril (författare)
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- Zetterberg, Henrik, 1973 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
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Vik, Anne (författare)
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- Blennow, Kaj, 1958 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
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Olsen, Alexander (författare)
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Håberg, Asta Kristine (författare)
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: Journal of Neuroinflammation. - 1742-2094. ; 21:1
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Identifying individuals with intracranial injuries following mild traumatic brain injury (mTBI), i.e. complicated mTBI cases, is important for follow-up and prognostication. The main aims of our study were (1) to assess the temporal evolution of blood biomarkers of CNS injury and inflammation in individuals with complicated mTBI determined on computer tomography (CT) and magnetic resonance imaging (MRI); (2) to assess the corresponding discriminability of both single- and multi-biomarker panels, from acute to chronic phases after injury.Patients with mTBI (n=207), defined as Glasgow Coma Scale score between 13 and 15, loss of consciousness<30min and post-traumatic amnesia<24h, were included. Complicated mTBI - i.e., presence of any traumatic intracranial injury on neuroimaging - was present in 8% (n=16) on CT (CT+) and 12% (n=25) on MRI (MRI+). Blood biomarkers were sampled at four timepoints following injury: admission (within 72h), 2 weeks (±3 days), 3 months (±2 weeks) and 12 months (±1 month). CNS biomarkers included were glial fibrillary acidic protein (GFAP), neurofilament light (NFL) and tau, along with 12 inflammation markers.The most discriminative single biomarkers of traumatic intracranial injury were GFAP at admission (CT+:AUC=0.78; MRI+:AUC=0.82), and NFL at 2 weeks (CT+:AUC=0.81; MRI+:AUC=0.89) and 3 months (MRI+:AUC=0.86). MIP-1β and IP-10 concentrations were significantly lower across follow-up period in individuals who were CT+and MRI+. Eotaxin and IL-9 were significantly lower in individuals who were MRI+only. FGF-basic concentrations increased over time in MRI- individuals and were significantly higher than MRI+individuals at 3 and 12 months. Multi-biomarker panels improved discriminability over single biomarkers at all timepoints (AUCs>0.85 for admission and 2-week models classifying CT+and AUC≈0.90 for admission, 2-week and 3-month models classifying MRI+).The CNS biomarkers GFAP and NFL were useful single diagnostic biomarkers of complicated mTBI, especially in acute and subacute phases after mTBI. Several inflammation markers were suppressed in patients with complicated versus uncomplicated mTBI and remained so even after 12 months. Multi-biomarker panels improved diagnostic accuracy at all timepoints, though at acute and 2-week timepoints, the single biomarkers GFAP and NFL, respectively, displayed similar accuracy compared to multi-biomarker panels.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
Nyckelord
- Humans
- Male
- Biomarkers
- blood
- Female
- Magnetic Resonance Imaging
- methods
- Adult
- Middle Aged
- Tomography
- X-Ray Computed
- Brain Concussion
- diagnostic imaging
- blood
- complications
- Young Adult
- Neurofilament Proteins
- blood
- Glial Fibrillary Acidic Protein
- blood
- Aged
- Time Factors
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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