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Correlation of Blood Biomarkers and Biomarker Panels with Traumatic Findings on Computed Tomography after Traumatic Brain Injury.

Accepted version
Peer-reviewed

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Article

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Authors

Posti, Jussi P 
Takala, Riikka SK 
Lagerstedt, Linnéa 
Dickens, Alex M 
Hossain, Iftakher 

Abstract

The aim of the study was to examine the ability of eight protein biomarkers and their combinations in discriminating computed tomography (CT)-negative and CT-positive patients with traumatic brain injury (TBI), utilizing highly sensitive immunoassays in a well-characterized cohort. Blood samples were obtained from 160 patients with acute TBI within 24 h of admission. Levels of β-amyloid isoforms 1-40 (Aβ40) and 1-42 (Aβ42), glial fibrillary acidic protein (GFAP), heart fatty-acid binding protein (H-FABP), interleukin 10 (IL-10), neurofilament light (NF-L), S100 calcium-binding protein B (S100B), and tau were measured. Patients were divided into CT-negative (n = 65) and CT-positive (n = 95), and analyses were conducted separately for TBIs of all severities (Glasgow Coma Scale [GCS] score 3-15) and mild TBIs (mTBIs; GCS 13-15). NF-L, GFAP, and tau were the best in discriminating CT-negative and CT-positive patients, both in patients with mTBI and with all severities. In patients with all severities, area under the curve of the receiver operating characteristic (AUC) was 0.822, 0.817, and 0.781 for GFAP, NF-L, and tau, respectively. In patients with mTBI, AUC was 0.720, 0.689, and 0.676, for GFAP, tau, and NF-L, respectively. The best panel of three biomarkers for discriminating CT-negative and CT-positive patients in the group of all severities was a combination of GFAP+H-FABP+IL-10, with a sensitivity of 100% and specificity of 38.5%. In patients with mTBI, the best panel of three biomarkers was H-FABP+S100B+tau, with a sensitivity of 100% and specificity of 46.4%. Panels of biomarkers outperform individual biomarkers in separating CT-negative and CT-positive patients. Panels consisted mainly of different biomarkers than those that performed best as an individual biomarker.

Description

Keywords

biomarkers, computed tomography, traumatic brain injury, Adult, Aged, Biomarkers, Brain Injuries, Traumatic, Fatty Acid Binding Protein 3, Female, Glial Fibrillary Acidic Protein, Humans, Interleukin-10, Male, Middle Aged, Sensitivity and Specificity, Tomography, X-Ray Computed

Journal Title

J Neurotrauma

Conference Name

Journal ISSN

0897-7151
1557-9042

Volume Title

36

Publisher

Mary Ann Liebert Inc
Sponsorship
Academy of Medical Sciences (unknown)
Medical Research Council (G1002277)
European Commission (270259)
Medical Research Council (G0601025)
Medical Research Council (G0600986)
Medical Research Council (G9439390)
NETSCC (None)
NETSCC (None)
TCC (None)
Medical Research Council (G0600986/1)
Medical Research Council (G1002277/1)