Examining four blood biomarkers for the detection of acute intracranial abnormalities following mild traumatic brain injury in older adults.

Autor:	Iverson GL; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States.; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, United States.; Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA, United States., Minkkinen M; Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland., Karr JE; Department of Psychology, University of Kentucky, Lexington, KY, United States., Berghem K; Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland., Zetterberg H; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.; UK Dementia Research Institute at University College London, London, United Kingdom.; Department of Neurodegenerative Disease, University College London Queen Square Institute of Neurology, London, United Kingdom.; Hong Kong Center for Neurodegenerative Diseases, Hong Kong, Hong Kong SAR, China., Blennow K; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden., Posti JP; Neurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, Turku, Finland.; Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland., Luoto TM; Department of Neurosurgery, Tampere University Hospital and Tampere University, Tampere, Finland.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2022 Nov 22; Vol. 13, pp. 960741. Date of Electronic Publication: 2022 Nov 22 (Print Publication: 2022).
DOI:	10.3389/fneur.2022.960741
Abstrakt:	Blood-based biomarkers have been increasingly studied for diagnostic and prognostic purposes in patients with mild traumatic brain injury (MTBI). Biomarker levels in blood have been shown to vary throughout age groups. Our aim was to study four blood biomarkers, glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), neurofilament light (NF-L), and total tau (t-tau), in older adult patients with MTBI. The study sample was collected in the emergency department in Tampere University Hospital, Finland, between November 2015 and November 2016. All consecutive adult patients with head injury were eligible for inclusion. Serum samples were collected from the enrolled patients, which were frozen and later sent for biomarker analyses. Patients aged 60 years or older with MTBI, head computed tomography (CT) imaging, and available biomarker levels were eligible for this study. A total of 83 patients (mean age = 79.0, SD = 9.58, range = 60-100; 41.0% men) were included in the analysis. GFAP was the only biomarker to show statistically significant differentiation between patients with and without acute head CT abnormalities [U (83) = 280, p < 0.001, r = 0.44; area under the curve (AUC) = 0.79, 95% CI = 0.67-0.91]. The median UCH-L1 values were modestly greater in the abnormal head CT group vs. normal head CT group [U (83) = 492, p = 0.065, r = 0.20; AUC = 0.63, 95% CI = 0.49-0.77]. Older age was associated with biomarker levels in the normal head CT group, with the most prominent age associations being with NF-L ( r = 0.56) and GFAP ( r = 0.54). The results support the use of GFAP in detecting abnormal head CT findings in older adults with MTBIs. However, small sample sizes run the risk for producing non-replicable findings that may not generalize to the population and do not translate well to clinical use. Further studies should consider the potential effect of age on biomarker levels when establishing clinical cut-off values for detecting head CT abnormalities. Competing Interests: Author GI serves as a scientific advisor for NanoDX®, Sway Operations, LLC, and Highmark, Inc. He has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mild TBIs. He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has received research funding as a principal investigator from the National Football League, and subcontract grant funding as a collaborator from the Harvard Integrated Program to Protect and Improve the Health of National Football League Players Association Members. Author JP has received a speaker's fee Finnish Medical Association. Author HZ has served at scientific advisory boards and/or as a consultant for Abbvie, Alector, Annexon, Apellis, Artery Therapeutics, AZTherapies, CogRx, Denali, Eisai, Nervgen, Novo Nordisk, Pinteon Therapeutics, Red Abbey Labs, Passage Bio, Roche, Samumed, Siemens Healthineers, Triplet Therapeutics, and Wave, has given lectures in symposia sponsored by Cellectricon, Fujirebio, Alzecure, Biogen, and Roche, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program. Author KajB has served as a consultant or at advisory boards for Alzheon, BioArctic, Biogen, Eli Lilly, Fujirebio Europe, IBL International, Merck, Novartis, Pfizer, and Roche Diagnostics, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB, a GU Venture-based platform company at the University of Gothenburg. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Iverson, Minkkinen, Karr, Berghem, Zetterberg, Blennow, Posti and Luoto.)
Databáze:	MEDLINE
Externí odkaz: