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Introduction Around 50% of the general population will suffer a traumatic brain injury (TBI) during their lifetime and about 80-90% of those will be mild TBIs. Currently the main diagnostic modality for TBI is computed tomography (CT). However, CT scans are costly and expose the patients to radiation. Therefore, a need exists for biochemical biomarkers that may detect mild TBI with reliable diagnostic accuracy. Materials and methods A literature search was performed using the MEDLINE, Scopus, Web of Science and Google scholar databases with the keywords “biomarkers” and “mild traumatic brain injury”. Original research articles were included that desribe the diagnostic accuracy and characteristics of select biomarkers in mild TBI. Results If performed within 3 hours from the traumatic event, S100B is a reliable marker of mild TBI (96.4% sensitivity, 33.4% specificity, negative predictive value 99.6%). Glial fibrillary acid protein (GFAP) has been shown to predict the need for CT scans with an area under the curve (AUC) of 0.86 and the need for neurosurgical intervention with an AUC of 0.94. Combinations of biomarkers are showing promising results: a combined assay of heart fatty acid binding protein (H-FABP), GFAP, S100B and interleukin-10 (IL-10) demonstrated 100% sensitivity and 55.9% specificity for diagnosing mild TBI. Conclusion Although biomarkers for mild TBI have satisfactory sensitivities, their clinical use is limited due to their low specificities. Combined assays show promise and higher specificities than singular biomarkers, without sacrificing sensitivity. Future research should be aimed at discovering the optimal combination of mild TBI biomarkers. |
