| Autor: |
Wilde EA; TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA.; George E Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA.; H Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA., Wanner IB; Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine University of California, Los Angeles, California, USA., Kenney K; Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA., Gill J; Department of Nursing and Medicine, Johns Hopkins University, Baltimore, Maryland, USA., Stone JR; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA., Disner S; Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA., Schnakers C; Research Institute, Casa Colina Hospital and Center for Healthcare, Pomona, California, USA., Meyer R; Delix Therapeutics, Inc., Boston, Massachusetts, USA.; Cohen Veterans Bioscience, New York, New York, USA., Prager EM; Cohen Veterans Bioscience, New York, New York, USA., Haas M; Cohen Veterans Bioscience, New York, New York, USA., Jeromin A; Cohen Veterans Bioscience, New York, New York, USA. |
| Abstrakt: |
Multi-modal biomarkers (e.g., imaging, blood-based, physiological) of unique traumatic brain injury (TBI) endophenotypes are necessary to guide the development of personalized and targeted therapies for TBI. Optimal biomarkers will be specific, sensitive, rapidly and easily accessed, minimally invasive, cost effective, and bidirectionally translatable for clinical and research use. For both uses, understanding how TBI biomarkers change over time is critical to reliably identify appropriate time windows for an intervention as the injury evolves. Biomarkers that enable researchers and clinicians to identify cellular injury and monitor clinical improvement, inflection, arrest, or deterioration in a patient's clinical trajectory are needed for precision healthcare. Prognostic biomarkers that reliably predict outcomes and recovery windows to assess neurodegenerative change and guide decisions for return to play or duty are also important. TBI biomarkers that fill these needs will transform clinical practice and could reduce the patient's risk for long-term symptoms and lasting deficits. This article summarizes biomarkers currently under investigation and outlines necessary steps to achieve short- and long-term goals, including how biomarkers can advance TBI treatment and improve care for patients with TBI. |
