Biomarkers in traumatic brain injury: new concepts.
Dana SlavoacaDafin F MuresanuCodruta BirleOlivia Verisezan RosuIoana ChirilaIulia DobraNicoleta JemnaStefan StrilciucPieter VosPublished in: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2020)
Traumatic brain injury is a multifaceted condition that encompasses a spectrum of injuries: contusions, axonal injuries in specific brain regions, edema, and hemorrhage. Brain injury determines a broad clinical and disability spectrum due to the implication of various cellular pathways, genetic phenotypes, and environmental factors. It is challenging to predict patient outcomes, to appropriately evaluate the patients, to determine a suitable treatment strategy and rehabilitation program, and to communicate with patient relatives. Biomarkers detected from body fluids are potential evaluation tools for traumatic brain injury patients. These may serve as internal indicators of cerebral damage, delivering valuable information about the dynamic cellular, biochemical, and molecular environments. The diagnostic and prognostic value of biomarkers tested both in animal models of traumatic brain injury is still under question, despite a considerable scientific literature. Recent publications emphasize that a more realistic approach involves combining multiple types of biomarkers with other investigative tools (imaging, outcome scales, and genetic polymorphisms). Additionally, there is increasing interest in the use of biomarkers as tools for treatment monitoring and as surrogate outcome variables to facilitate the design of distinct randomized controlled trials. This review highlights the latest available evidence regarding biomarkers in adults after traumatic brain injury and discusses new approaches in the evaluation of this patient group.
Keyphrases
- traumatic brain injury
- brain injury
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- randomized controlled trial
- subarachnoid hemorrhage
- systematic review
- cerebral ischemia
- peritoneal dialysis
- healthcare
- high resolution
- case report
- multiple sclerosis
- severe traumatic brain injury
- dna methylation
- clinical trial
- oxidative stress
- genome wide
- prognostic factors
- mass spectrometry
- resting state
- white matter
- blood brain barrier
- climate change