Serum Levels of Biochemical Markers of Traumatic Brain Injury

Keith Borg,Peter Kupchak,Edward C Jauch,Eric B Stanton,Jordan Bonomo,Bruce Sawadsky

doi:10.5402/2012/417313

Abstract

Background. A biomarker would be valuable in the diagnosis, risk stratification and prognosis of patients with traumatic brain injury (TBI). Methods. We measured serum levels of S-100β, neuron specific enolase (NSE) and myelin basic protein (MBP) in 50 TBI subjects, and 50 age and gender matched controls. Patients were recruited within 6 hours of the initial injury, they had an initial Glasgow Coma Scale (GCS) score of 14 or less, or a GCS score of 15 with witnessed loss of consciousness (LOC) or amnesia. Results. S-100β, NSE and MBP levels were significantly higher in TBI subjects than in control subjects (P<0.001 for S-100β and NSE; P=0.009 for MBP). Initial S-100β levels were significantly higher in TBI subjects who had not retuned to normal activities 2 weeks following their injury than in TBI subjects who had retuned to normal activities (P=0.022). MBP levels were higher in TBI subjects with positive findings on the baseline CT scan than in CT-negative subjects (P=0.007). Conclusions. S-100β, NSE and MBP may be present in the sera of TBI subjects in elevated quantities relative to controls. S-100β may aid in predicting short-term outcome in TBI subjects.

Highlights

1.4 million people sustain a traumatic brain injury (TBI) in the United States each year [1] (CDC ref.) [2, 3]
Computerized axial tomography (CT) scanning is currently accepted as the “gold” standard diagnostic procedure for initial evaluation of TBI, as it identifies pathology associated with primary brain injury [4], is widely available, and can be performed at a relatively low cost [5]; the utilization of CT scanning in the diagnosis and management of patients presenting to emergency departments (EDs) with TBI varies among institutions, and CT scan results in isolation have limited fidelity in predicting neuropsychiatric outcome in mild TBI subjects [6]
Control subjects were patients who presented to the ED with a condition unrelated to head trauma, a Glasgow Coma Scale (GCS) score of 15 without prepresentation witnessed loss of consciousness (LOC), or amnesia, were of the same gender and within 3 years of age of an enrolled TBI subject

Summary

Introduction

1.4 million people sustain a traumatic brain injury (TBI) in the United States each year [1] (CDC ref.) [2, 3]. Computerized axial tomography (CT) scanning is currently accepted as the “gold” standard diagnostic procedure for initial evaluation of TBI, as it identifies pathology associated with primary brain injury [4], is widely available, and can be performed at a relatively low cost [5]; the utilization of CT scanning in the diagnosis and management of patients presenting to emergency departments (EDs) with TBI varies among institutions, and CT scan results in isolation have limited fidelity in predicting neuropsychiatric outcome in mild TBI subjects [6]. We measured serum levels of S-100β, neuron specific enolase (NSE) and myelin basic protein (MBP) in 50 TBI subjects, and 50 age and gender matched controls. S-100β, NSE and MBP levels were significantly higher in TBI subjects than in control subjects (P < 0.001 for S-100β and NSE; P = 0.009 for MBP). S-100β may aid in predicting short-term outcome in TBI subjects

Objectives

Methods

Results

Conclusion