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brain trauma traumatic injury biomarker

William Peacock
Dear Editor I read with great interest the manuscript titled "A New Panel of Blood Biomarkers for the Diagnosis of Mild Traumatic Brain Injury/Concussion in Adults" by Shan R, et al, published in the January issue of the Journal. (1) I do have some questions. The key to marker discovery studies is a precise and accurate description of how the population was identified, including controls. I have significant concerns about the control population in the manuscript. In the presentation the characteristics of the control group are unclear, described only as "not patients in the ED" and with the same exclusion criteria of the other cohorts...
October 18, 2016: Journal of Neurotrauma
Alison Halstrom, Ellen MacDonald, Claire Neil, Glenn Arendts, Daniel Fatovich, Melinda Fitzgerald
Traumatic brain injury (TBI) encompasses a broad range of injury mechanisms and severity. A detailed determination of TBI severity can be a complex challenge, with current clinical tools sometimes insufficient to tailor a clinical response to a spectrum of patient needs. Blood biomarkers of TBI may supplement clinical assessments but currently available biomarkers have limited sensitivity and specificity. While oxidative stress is known to feature in damage mechanisms following TBI, investigation of blood biomarkers of oxidative stress has been limited...
September 30, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jie Ma, Wenjing Xiao, Junrui Wang, Juan Wu, Jiandong Ren, Jun Hou, Jianwen Gu, Kaihua Fan, Botao Yu
Increasing evidence has demonstrated that inflammatory response plays a crucial role in the pathogenesis of secondary injury following blast-induced traumatic brain injury (bTBI). Propofol, a lipid-soluble intravenous anesthetic, has been shown to possess therapeutic benefit during neuroinflammation on various brain injury models. Recent findings have proved that the NOD-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome involved in the process of the inflammatory response following brain trauma, may probably be a promising target in the treatment of bTBI...
September 30, 2016: Inflammation
Eric Peter Thelin, Emma Jeppsson, Arvid Frostell, Mikael Svensson, Stefania Mondello, Bo-Michael Bellander, David W Nelson
BACKGROUND: In order to improve assessment and outcome prediction in patients suffering from traumatic brain injury (TBI), cerebral protein levels in serum have been suggested as biomarkers of injury. However, despite much investigation, biomarkers have yet to reach broad clinical utility in TBI. This study is a 9-year follow-up and clinical experience of the two most studied proteins, neuron-specific enolase (NSE) and S100B, in a neuro-intensive care TBI population. Our aims were to investigate to what extent NSE and S100B, independently and in combination, could predict outcome, assess injury severity, and to investigate if the biomarker levels were influenced by extracranial factors...
September 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
D Allan Butterfield, Tanea T Reed
Traumatic brain injury (TBI) is a spontaneous event in which sudden trauma and secondary injury cause brain damage. Symptoms of TBI can range from mild to severe depending on extent of injury. The outcome can span from complete patient recovery to permanent memory loss and neurological decline. Currently, there is no known cure for TBI; however, immediate medical attention after injury is most beneficial for patient recovery. It is a well-established concept that imbalances in the production of reactive oxygen species (ROS), reactive nitrogen species (RNS), and native antioxidant mechanisms have been shown to increase oxidative stress...
September 2, 2016: Proteomics. Clinical Applications
Jinbing Zhao, Haodong Chen, Meijuan Zhang, Yuhai Zhang, Chunfa Qian, Yong Liu, Shengxue He, Yuanjie Zou, Hongyi Liu
PURPOSE: Intracranial bleeding and inflammatory reactions are common consequences of traumatic brain injury (TBI). Neutrophil gelatinase-associated lipocalin (NGAL), an iron-handling and acute phase protein, may participate in the pathogenesis of TBI. Therefore, we hypothesize that NGAL may be of high diagnostic and therapeutic relevance in the prognosis of TBI. METHODS: 74 subjects were recruited in this study. 30 TBI patients receiving emergent operation were designated as severe TBI group (sTBI), 24 TBI patients receiving conservative treatment as mild TBI group (mTBI), while 20 age-matched healthy volunteers as healthy controls (CNT)...
September 15, 2016: Journal of the Neurological Sciences
Ying Wang, Yanling Wei, Samuel Oguntaya, Donna Wilder, Lawrence Tong, Yan Su, Irene Gist, Peethambaran Arun, Joseph Long
Chemokines and their receptors are of great interest within the milieu of immune responses elicited in CNS in response to trauma. Chemokine ligand 2 (CCL2), which is also known as monocyte chemotactic protein-1 (MCP-1), has been implicated in the pathogenesis of traumatic brain injury, brain ischemia, Alzheimer's disease and other neurodegenerative diseases. In this study, we investigated the time-course of CCL2 accumulation in cerebrospinal fluid (CSF) following exposures to single and repeated blast overpressures of varied intensities along with the neuropathological changes and motor deficits resulting from these blast conditions...
August 3, 2016: Journal of Neurotrauma
Marius Papurica, Alexandru F Rogobete, Dorel Sandesc, Raluca Dumache, Carmen A Cradigati, Mirela Sarandan, Radu Nartita, Sonia E Popovici, Ovidiu H Bedreag
BACKGROUND: The complexity of the cases of critically ill polytrauma patients is given by both the primary, as well as the secondary, post-traumatic injuries. The severe injuries of organ systems, the major biochemical and physiological disequilibrium, and the molecular chaos lead to a high rate of morbidity and mortality in this type of patient. The 'gold goal' in the intensive therapy of such patients resides in the continuous evaluation and monitoring of their clinical status. Moreover, optimizing the therapy based on the expression of certain biomarkers with high specificity and sensitivity is extremely important because of the clinical course of the critically ill polytrauma patient...
2016: Clinical Laboratory
Ernest M Graham, Irina Burd, Allen D Everett, Frances J Northington
Recent research in identification of brain injury after trauma shows many possible blood biomarkers that may help identify the fetus and neonate with encephalopathy. Traumatic brain injury shares many common features with perinatal hypoxic-ischemic encephalopathy. Trauma has a hypoxic component, and one of the 1st physiologic consequences of moderate-severe traumatic brain injury is apnea. Trauma and hypoxia-ischemia initiate an excitotoxic cascade and free radical injury followed by the inflammatory cascade, producing injury in neurons, glial cells and white matter...
2016: Frontiers in Pharmacology
Enyinna L Nwachuku, Ava M Puccio, Adeolu Adeboye, Yue-Fang Chang, Jinho Kim, David O Okonkwo
OBJECTIVE: Activation of the inflammatory cascade is a known pathophysiologic process in severe traumatic brain injury (TBI) with yet non-standardized scientific data regarding relationship to outcome. The understanding of the time course of expression of cerebrospinal fluid (CSF) biomarker levels following severe TBI is an important step toward using these biomarkers to measure injury severity and/or early response to therapeutic interventions. The objective of the current study is to report the time course and values of a battery of CSF inflammatory biomarkers following severe TBI in our reasonably sized patient cohort...
October 2016: Clinical Neurology and Neurosurgery
A Ercole, E P Thelin, A Holst, B M Bellander, D W Nelson
BACKGROUND: An understanding of the kinetics of a biomarker is essential to its interpretation. Despite this, little kinetic modelling of blood biomarkers can be found in the literature. S100b is an astrocyte related marker of brain injury used primarily in traumatic brain injury (TBI). Serum levels are expected to be the net result of a multi-compartmental process. The optimal sample times for TBI prognostication, and to follow injury development, are unclear. The purpose of this study was to develop a kinetic model to characterise the temporal course of serum S100b concentration after primary traumatic brain injury...
2016: BMC Neurology
H Wolf, C Krall, G Pajenda, S Hajdu, H Widhalm, J Leitgeb, K Sarahrudi
BACKGROUND: Despite several experimental studies on the role of S100B and NSE in fractures, no studies on the influence of surgery on the biomarker serum levels have been performed yet. METHODS: The serum levels of S100B and NSE were analysed in patients with fractures that were located in the spine (group 1, n = 35) or in the lower extremity (group 2, n = 32) pre- and post-operatively. RESULTS: The mean S100B serum level showed a significant increase (p = 0...
2016: Brain Injury: [BI]
Matthew A Albrecht, Colin L Masters, David Ames, Jonathan K Foster
Traumatic brain injury (TBI) is suggested to be a significant risk factor for dementia. However, little research has been conducted into long-term neuropsychological outcomes after head trauma. Participants from the Australian Imaging, Biomarkers and Lifestyle Study of Ageing (AIBL) who had recovered after sustaining a mild TBI involving loss of consciousness more than 5 years previously were compared with matched controls across a 3-year period. Bayesian nested-domain modeling was used to estimate the effect of TBI on neuropsychological performance...
2016: Frontiers in Aging Neuroscience
Alex P Di Battista, Sandro B Rizoli, Brandon Lejnieks, Arimie Min, Maria Y Shiu, Henry T Peng, Andrew J Baker, Michael G Hutchison, Nathan Churchill, Kenji Inaba, Bartolomeu B Nascimento, Airton Leonardo de Oliveira Manoel, Andrew Beckett, Shawn G Rhind
BACKGROUND: Acute coagulopathy after traumatic brain injury (TBI) involves a complex multifactorial hemostatic response that is poorly characterized. OBJECTIVES: To examine early posttraumatic alterations in coagulofibrinolytic, endothelial, and inflammatory blood biomarkers in relation to sympathetic nervous system (SNS) activation and 6-month patient outcomes, using multivariate partial least-squares (PLS) analysis. PATIENTS AND METHODS: A multicenter observational study of 159 adult isolated TBI patients admitted to the emergency department at an urban level I trauma center, was performed...
September 2016: Shock
Gang-Qun Wu, Xiao-Min Chou, Wen-Jian Ji, Xiao-Gang Yang, Luo-Xin Lan, Yan-Jun Sheng, Yang-Fang Shen, Jian-Rong Li, Guo-Zhong Huang, Wen-Hua Yu, Xiao-Qiao Dong, Quan Du, Ding-Bo Yang, Zu-Yong Zhang, Hao Wang, Yong-Feng Shen, Li Jiang
BACKGROUND: Nesfatin-1 is related to inflammation. Its increased circulating concentrations are associated with the severity and prognosis of subarachnoid hemorrhage. In-hospital major adverse events (IMAEs), including acute traumatic coagulopathy, progressive hemorrhagic injury and posttraumatic cerebral infarction, are correlated with mortality after traumatic brain injury (TBI). The present study was designed to investigate the changes of plasma nesfatin-1 concentrations and further assess its association with inflammation, trauma severity, in-hospital mortality and IMAEs following TBI...
July 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Wen Huang, Shang-xun Li, Xue-jian Li, Hong-yun Xu
Mild traumatic brain injury (MTBI) is defined as a mild brain trauma resulting in a short loss of consciousness and alteration of mental status. It may also occasionally develop persistent and progressive symptoms. It has been confirmed that MTBI causes changes of anatomic structures in central nervous system and biomarkers in the body fluid. However, there is no sufficient research on relevance among threshold for the brain injury, individual vulnerability and duration of disturbance of consciousness. Furthermore, there are no reliable diagnostic methods to establish whether a blow to the head is sufficient to cause the brain injury...
December 2015: Fa Yi Xue za Zhi
Linda Papa, Gretchen M Brophy, Robert D Welch, Lawrence M Lewis, Carolina F Braga, Ciara N Tan, Neema J Ameli, Marco A Lopez, Crystal A Haeussler, Diego I Mendez Giordano, Salvatore Silvestri, Philip Giordano, Kurt D Weber, Crystal Hill-Pryor, Dallas C Hack
IMPORTANCE: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. OBJECTIVES: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention...
May 1, 2016: JAMA Neurology
Eric Peter Thelin, Arvid Frostell, Jan Mulder, Nicholas Mitsios, Peter Damberg, Sahar Nikkhou Aski, Mårten Risling, Mikael Svensson, Maria Cristina Morganti-Kossmann, Bo-Michael Bellander
BACKGROUND: Hypoxia following traumatic brain injury (TBI) is a severe insult shown to exacerbate the pathophysiology, resulting in worse outcome. The aim of this study was to investigate the effects of a hypoxic insult in a focal TBI model by monitoring brain edema, lesion volume, serum biomarker levels, immune cell infiltration, as well as the expression of hypoxia-inducible factor-1 alpha (HIF-1α) and vascular endothelial growth factor (VEGF). MATERIALS AND METHODS: Female Sprague-Dawley rats (n = 73, including sham and naive) were used...
2016: Frontiers in Neurology
Junwen Wang, Jun Li, Lin Han, Songbo Guo, Lei Wang, Zuojun Xiong, Zhi Chen, Wen Chen, Jian Liang
Traumatic brain injury (TBI) is the leading cause of mortality and disabilities among all trauma cases. Following TBI, damage to axons results in τ protein hyperphosphorylation leading to microtubule instability and τ-mediated neurodegeneration. In addition, τ protein is proteolytically cleaved and is able to access the cerebrospinal fluid (CSF) and serum; thus, this protein may serve as a potential biomarker in the diagnosis of injury severity and outcome prediction. Although a limited number of studies have investigated the CSF τ protein levels after TBI, the data are divergent and conflicting, and investigations into the serum τ protein levels have yet to be conducted...
March 2016: Experimental and Therapeutic Medicine
Dominic E Nathan, Julie F Bellgowan, Terrence R Oakes, Louis M French, Sreenivasan R Nadar, Elyssa B Sham, Wei Liu, Gerard Riedy
In the global war on terror, the increased use of improvised explosive devices has resulted in increased incidence of blast-related mild traumatic brain injury (mTBI). Diagnosing mTBI is both challenging and controversial due to heterogeneity of injury location, trauma intensity, transient symptoms, and absence of focal biomarkers on standard clinical imaging modalities. The goal of this study is to identify a brain biomarker that is sensitive to mTBI injury. Research suggests the thalamus may be sensitive to changes induced by mTBI...
June 2016: Brain Connectivity
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