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dc.contributor.authorNewcombe, Virginia FJ
dc.contributor.authorAshton, Nicholas J
dc.contributor.authorPosti, Jussi P
dc.contributor.authorGlocker, Ben
dc.contributor.authorManktelow, Anne
dc.contributor.authorChatfield, Doris A
dc.contributor.authorWinzeck, Stefan
dc.contributor.authorNeedham, Edward
dc.contributor.authorCorreia, Marta M
dc.contributor.authorWilliams, Guy B
dc.contributor.authorSimrén, Joel
dc.contributor.authorTakala, Riikka SK
dc.contributor.authorKatila, Ari J
dc.contributor.authorMaanpää, Henna Riikka
dc.contributor.authorTallus, Jussi
dc.contributor.authorFrantzén, Janek
dc.contributor.authorBlennow, Kaj
dc.contributor.authorTenovuo, Olli
dc.contributor.authorZetterberg, Henrik
dc.contributor.authorMenon, David K
dc.date.accessioned2022-04-07T08:48:51Z
dc.date.available2022-04-07T08:48:51Z
dc.date.issued2022-06-30
dc.identifier.issn0006-8950
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/335861
dc.description.abstractThere is substantial interest in the potential for traumatic brain injury to result in progressive neurological deterioration. While blood biomarkers such as glial fibrillary acid protein (GFAP) and neurofilament light have been widely explored in characterizing acute traumatic brain injury (TBI), their use in the chronic phase is limited. Given increasing evidence that these proteins may be markers of ongoing neurodegeneration in a range of diseases, we examined their relationship to imaging changes and functional outcome in the months to years following TBI. Two-hundred and three patients were recruited in two separate cohorts; 6 months post-injury (n = 165); and >5 years post-injury (n = 38; 12 of whom also provided data ∼8 months post-TBI). Subjects underwent blood biomarker sampling (n = 199) and MRI (n = 172; including diffusion tensor imaging). Data from patient cohorts were compared to 59 healthy volunteers and 21 non-brain injury trauma controls. Mean diffusivity and fractional anisotropy were calculated in cortical grey matter, deep grey matter and whole brain white matter. Accelerated brain ageing was calculated at a whole brain level as the predicted age difference defined using T1-weighted images, and at a voxel-based level as the annualized Jacobian determinants in white matter and grey matter, referenced to a population of 652 healthy control subjects. Serum neurofilament light concentrations were elevated in the early chronic phase. While GFAP values were within the normal range at ∼8 months, many patients showed a secondary and temporally distinct elevations up to >5 years after injury. Biomarker elevation at 6 months was significantly related to metrics of microstructural injury on diffusion tensor imaging. Biomarker levels at ∼8 months predicted white matter volume loss at >5 years, and annualized brain volume loss between ∼8 months and 5 years. Patients who worsened functionally between ∼8 months and >5 years showed higher than predicted brain age and elevated neurofilament light levels. GFAP and neurofilament light levels can remain elevated months to years after TBI, and show distinct temporal profiles. These elevations correlate closely with microstructural injury in both grey and white matter on contemporaneous quantitative diffusion tensor imaging. Neurofilament light elevations at ∼8 months may predict ongoing white matter and brain volume loss over >5 years of follow-up. If confirmed, these findings suggest that blood biomarker levels at late time points could be used to identify TBI survivors who are at high risk of progressive neurological damage.
dc.language.isoen
dc.publisherOxford University Press (OUP)
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.titlePost-acute blood biomarkers and disease progression in traumatic brain injury.
dc.typeArticle
dc.publisher.departmentDepartment of Medicine
dc.publisher.departmentMrc Cognition And Brain Sciences Unit
dc.date.updated2022-04-06T14:05:15Z
prism.publicationNameBrain
dc.identifier.doi10.17863/CAM.83294
dcterms.dateAccepted2022-02-13
rioxxterms.versionofrecord10.1093/brain/awac126
rioxxterms.versionAM
dc.contributor.orcidNewcombe, Virginia FJ [0000-0001-6044-9035]
dc.contributor.orcidNeedham, Edward [0000-0001-7042-7462]
dc.contributor.orcidCorreia, Marta M [0000-0002-3231-7040]
dc.contributor.orcidSimrén, Joel [0000-0001-5081-6604]
dc.contributor.orcidZetterberg, Henrik [0000-0003-3930-4354]
dc.contributor.orcidMenon, David K [0000-0002-3228-9692]
dc.identifier.eissn1460-2156
rioxxterms.typeJournal Article/Review
pubs.funder-project-idAcademy of Medical Sciences (unknown)
pubs.funder-project-idBiotechnology and Biological Sciences Research Council (BB/H008217/1)
pubs.funder-project-idMedical Research Council (G9439390)
pubs.funder-project-idEuropean Commission (270259)
cam.issuedOnline2022-06-02
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cam.depositDate2022-04-06
pubs.licence-identifierapollo-deposit-licence-2-1
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
rioxxterms.freetoread.startdate2023-06-02


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