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Singh AK, Asif S, Pandey DK, Chaudhary A, Kapoor V, Verma PK. Biomarkers in Acute Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e63020. [PMID: 39050316 PMCID: PMC11268976 DOI: 10.7759/cureus.63020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
Traumatic brain injury (TBI) stands as a significant contributor to traumatic death and disability worldwide. In recent years, researchers have identified biomarkers to gauge useful outcomes in TBI patients. However, the enigma of timely sample collection to measure the biomarkers remains a controversial point in the case of TBI, unlike other degenerative diseases like Alzheimer's disease and Parkinson's disease, where we can collect the sample at any point in time. The purpose of this study is to evaluate the sensitivity of biomarkers in TBI concerning time of injury by analyzing recent available data on biomarkers in the medical literature. A total of 2,256 studies were initially retrieved from the search engine. After an initial screening, only 1,750 unique articles remained. After excluding review articles, animal studies, meta-analysis, and studies with children (screened by title and abstract), 30 kinds of literature were found relevant to search the required variables. Further 16 studies were excluded due to the nonavailability of complete variables or data. Finally, 14 studies remained and were included in the analysis. This study has analyzed the four most commonly described biomarkers for TBI in the literature: glial fibrillary acidic protein (GFAP), S100 calcium-binding protein B, ubiquitin carboxy-terminal hydrolase L1, and Tau. According to this statistical analysis, all biomarkers included in the study have shown their serum levels after trauma. So, all these biomarkers can be used for further study in the outcome prediction and diagnosis of TBI patients. The meta-analysis suggests that the best biomarker for TBI is Tau in cases where sample collection is done within 24 hours, while GFAP is the best biomarker to be studied for TBI if sample collection is done 24 hours after trauma.
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Affiliation(s)
- Adarsh Kumar Singh
- Department of Biotechnology, Centre of BioMedical Research (CBMR) Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND
| | - Shafaque Asif
- Department of Molecular Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND
| | - Deepika Kumari Pandey
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND
| | - Akash Chaudhary
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND
| | - Vishwas Kapoor
- Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND
| | - Pawan Kumar Verma
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND
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Zhou F, Wu L, Qian L, Kuang H, Zhan J, Li J, Cheung GL, Ding A, Gong H. The Relationship Between Cortical Morphological and Functional Topological Properties and Clinical Manifestations in Patients with Posttraumatic Diffuse Axonal Injury: An Individual Brain Network Study. Brain Topogr 2023; 36:936-945. [PMID: 37615797 DOI: 10.1007/s10548-023-00964-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/15/2023] [Indexed: 08/25/2023]
Abstract
To evaluate the altered network topological properties and their clinical relevance in patients with posttraumatic diffuse axonal injury (DAI). Forty-seven participants were recruited in this study, underwent 3D T1-weighted and resting-state functional MRI, and had single-subject morphological brain networks (MBNs) constructed by Kullback-Leibler divergence and functional brain networks (FBNs) constructed by Pearson correlation measurement interregional similarity. The global and regional properties were analyzed and compared using graph theory and network-based statistics (NBS), and the relationship with clinical manifestations was assessed. Compared with those of the healthy subjects, MBNs of patients with DAI showed a higher path length ([Formula: see text]: P = 0.021, [Formula: see text]: P = 0.011), lower clustering ([Formula: see text]: P = 0.002) and less small-worldness ([Formula: see text]: P = 0.002), but there was no significant difference in the global properties of FBNs (P: 0.161-0.216). For nodal properties of MBNs and FBNs, several regions showed significant differences between patients with DAI and healthy controls (HCs) (P < 0.05, FDR corrected). NBS analysis revealed that MBNs have more altered morphological connections in the frontal parietal control network and interhemispheric connections (P < 0.05). DAI-related global or nodal properties of MBNs were correlated with physical disability or dyscognition (P < 0.05/7, with Bonferroni correction), and the alteration of functional topology properties mediates this relationship. Our results suggested that disrupted morphological topology properties, which are mediated by FBNs and correlated with clinical manifestations of DAI, play a critical role in the short-term and medium-term phases after trauma.
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Affiliation(s)
- Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Lin Wu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Long Qian
- Department of Biomedical Engineering, College of Engineering, Peking University, No.60 Yannan Yuan, Beijing, 100871, China
| | - Hongmei Kuang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Jie Zhan
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Jian Li
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Gerald L Cheung
- Spin Imaging Technology Co., Ltd, No.6 Fengxin Road, Nanjing, 210012, China
| | - Aimin Ding
- Department of Radiology, The First People's Hospital of Fuzhou and The Fifth Affiliated Hospital, Nanchang University, Fuzhou, 344000, China.
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China.
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China.
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Fang T, Yue L, Longlong Z, Longda M, Fang H, Yehui L, Yang L, Yiwu Z. Peripherin: A proposed biomarker of traumatic axonal injury triggered by mechanical force. Eur J Neurosci 2023; 58:3206-3225. [PMID: 37574217 DOI: 10.1111/ejn.16111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023]
Abstract
Traumatic axonal injury (TAI) is one of the most common pathological features of severe traumatic brain injury (TBI). Our previous study using proteomics suggested that peripherin (PRPH) should be a potential candidate as a biomarker for TAI diagnosis. This study is to further elucidate the role and association of PRPH with TAI. In the animal study, we performed immunohistochemistry, ELISA and morphological analysis to evaluate PRPH level and distribution following a severe impact. PRPH-positive regions were widely distributed in the axonal tract throughout the whole brain. Axonal injuries with PRPH inclusion were observed post-TBI. Besides, PRPH was significantly increased in both cerebral spinal fluid and plasma at the early phase post-TBI. Colocalization analysis based on microscopy revealed that PRPH represents an immunohistological biomarker in the neuropathological diagnosis of TAI. Brain samples from patients with TBI were included to further test whether PRPH is feasible in the real practice of neuropathology. Immunohistochemistry of PRPH, NFH, APP and NFL on human brain tissues further confirmed PRPH as an immunohistological biomarker that could be applied in practice. Collectively, we conclude that PRPH mirrors the cytoskeleton injury of axons and could represent a neuropathological biomarker for TAI.
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Affiliation(s)
- Tong Fang
- Department of Neurology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Institute of Wound Prevention and Treatment, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Physiology and Biochemistry, College of Fundamental Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Yue
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Pathology, Shanghai Medicilon Inc., Shanghai, China
| | - Zhu Longlong
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ma Longda
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huang Fang
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lv Yehui
- Institute of Wound Prevention and Treatment, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Human Anatomy and Histology, School of Fundamental Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Li Yang
- Institute of Forensic Science, Ministry of Public Security, People's Republic of China, Beijing, China
| | - Zhou Yiwu
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lampros M, Vlachos N, Tsitsopoulos PP, Zikou AK, Argyropoulou MI, Voulgaris S, Alexiou GA. The Role of Novel Imaging and Biofluid Biomarkers in Traumatic Axonal Injury: An Updated Review. Biomedicines 2023; 11:2312. [PMID: 37626808 PMCID: PMC10452517 DOI: 10.3390/biomedicines11082312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of disability worldwide. Traumatic axonal injury (TAI) is a subtype of TBI resulting from high-impact forces that cause shearing and/or stretching of the axonal fibers in white matter tracts. It is present in almost half of cases of severe TBI and frequently associated with poor functional outcomes. Axonal injury results from axonotomy due to mechanical forces and the activation of a biochemical cascade that induces the activation of proteases. It occurs at a cellular level; hence, conventional imaging modalities often fail to display TAI lesions. However, the advent of novel imaging modalities, such as functional magnetic resonance imaging and fiber tractography, has significantly improved the detection and characteristics of TAI. Furthermore, the significance of several fluid and structural biomarkers has also been researched, while the contribution of omics in the detection of novel biomarkers is currently under investigation. In the present review, we discuss the role of imaging modalities and potential biomarkers in diagnosing, classifying, and predicting the outcome in patients with TAI.
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Affiliation(s)
- Marios Lampros
- Department of Neurosurgery, School of Medicine, University of Ioannina, St. Niarhou Avenue, 45500 Ioannina, Greece; (M.L.); (N.V.); (S.V.)
| | - Nikolaos Vlachos
- Department of Neurosurgery, School of Medicine, University of Ioannina, St. Niarhou Avenue, 45500 Ioannina, Greece; (M.L.); (N.V.); (S.V.)
| | - Parmenion P. Tsitsopoulos
- Department of Neurosurgery, Hippokratio General Hospital, Aristotle University of Thessaloniki School of Medicine, 54942 Thessaloniki, Greece;
| | - Anastasia K. Zikou
- Department of Radiology, University of Ioannina, 45110 Ioannina, Greece; (A.K.Z.); (M.I.A.)
| | - Maria I. Argyropoulou
- Department of Radiology, University of Ioannina, 45110 Ioannina, Greece; (A.K.Z.); (M.I.A.)
| | - Spyridon Voulgaris
- Department of Neurosurgery, School of Medicine, University of Ioannina, St. Niarhou Avenue, 45500 Ioannina, Greece; (M.L.); (N.V.); (S.V.)
| | - George A. Alexiou
- Department of Neurosurgery, School of Medicine, University of Ioannina, St. Niarhou Avenue, 45500 Ioannina, Greece; (M.L.); (N.V.); (S.V.)
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Chen Q, Chen X, Xu L, Zhang R, Li Z, Yue X, Qiao D. Traumatic axonal injury: neuropathological features, postmortem diagnostic methods, and strategies. Forensic Sci Med Pathol 2022; 18:530-544. [PMID: 36117238 DOI: 10.1007/s12024-022-00522-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 12/14/2022]
Abstract
Traumatic brain injury (TBI) has high morbidity and poor prognosis and imposes a serious socioeconomic burden. Traumatic axonal injury (TAI), which is one of the common pathological changes in the primary injury of TBI, is often caused by the external force to the head that causes the white matter bundles to generate shear stress and tension; resulting in tissue damage and leading to the cytoskeletal disorder. At present, the forensic pathological diagnosis of TAI-caused death is still a difficult problem. Most of the TAI biomarkers studied are used for the prediction, evaluation, and prognosis of TAI in the living state. The research subjects are mainly humans in the living state or model animals, which are not suitable for the postmortem diagnosis of TAI. In addition, there is still a lack of recognized indicators for the autopsy pathological diagnosis of TAI. Different diagnostic methods and markers have their limitations, and there is a lack of systematic research and summary of autopsy diagnostic markers of TAI. Therefore, this study mainly summarizes the pathological mechanism, common methods, techniques of postmortem diagnosis, and corresponding biomarkers of TAI, and puts forward the strategies for postmortem diagnosis of TAI for forensic cases with different survival times, which is of great significance to forensic pathological diagnosis.
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Affiliation(s)
- Qianling Chen
- School of Forensic Medicine, Southern Medical University, South Shaitai Road #1023, Guangzhou, 510515, Guangdong, China
| | - Xuebing Chen
- School of Forensic Medicine, Southern Medical University, South Shaitai Road #1023, Guangzhou, 510515, Guangdong, China
| | - Luyao Xu
- School of Forensic Medicine, Southern Medical University, South Shaitai Road #1023, Guangzhou, 510515, Guangdong, China
| | - Rui Zhang
- School of Forensic Medicine, Southern Medical University, South Shaitai Road #1023, Guangzhou, 510515, Guangdong, China
| | - Zhigang Li
- Guangzhou Forensic Science Institute & Key Laboratory of Forensic Pathology, Ministry of Public Security, Guangzhou, 510442, China.
| | - Xia Yue
- School of Forensic Medicine, Southern Medical University, South Shaitai Road #1023, Guangzhou, 510515, Guangdong, China.
| | - Dongfang Qiao
- School of Forensic Medicine, Southern Medical University, South Shaitai Road #1023, Guangzhou, 510515, Guangdong, China.
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A review of molecular and genetic factors for determining mild traumatic brain injury severity and recovery. BRAIN DISORDERS 2022. [DOI: 10.1016/j.dscb.2022.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Siahaan AMP, Fernando ET. The Potential of S100 Calcium-Binding Protein B and Glial Fibrillary Acid Protein in Predicting the Intracranial Lesions in Mild Traumatic Brain Injury: A Systematic Review of Literature. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
ABSTRACT
AIM: To summarize the current evidence of S100B and GFAP in predicting intracranial lesions after mTBI.
MATERIAL AND METHODS: We searched publications on biomarkers in mTBI from Web of Science, PubMed, and Scopus between January 1990 and July 2021. We included RCTs, cohort, case control, and cross-sectional studies that involved patients with acute closed mTBI in all age group in which head CT scan and blood-based biomarkers (GFAP and S100B) examination were conducted under 24 hours. This study was registered in Open Science Framework.
RESULTS: The initial search identified 4.937 article, in which 127 were included for full-text assessment. A total of 16 articles were finally included. No RCT was found in literature searching. Thirteen studies were studying S100B and three studies were studying GFAP. Nine out of 13 S100B studies shows a promising result with ≥ 95% sensitivity for detecting intracranial lesions. Majorities (11 /13) studies of S100B confirmed that S100B reduced the unnecessary usage of CT scan. GFAP concentration significantly increased in CT+ patient than CT- patient. No specific GFAP cut off value between the studies was found.
CONCLUSION: The result showed that S100B and GFAP had potential to predict the occurrence of intracranial lesions. Variance between methodologies and cut off value hindered the quality of evidence, especially in GFAP.
KEYWORDS: mild traumatic brain injury, S100B, GFAP.
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Benaroya H. Brain energetics, mitochondria, and traumatic brain injury. Rev Neurosci 2021; 31:363-390. [PMID: 32004148 DOI: 10.1515/revneuro-2019-0086] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/13/2019] [Indexed: 12/13/2022]
Abstract
We review current thinking about, and draw connections between, brain energetics and metabolism, and between mitochondria and traumatic brain injury. Energy is fundamental to proper brain function. Its creation in a useful form for neurons and glia, and consistently in response to the brain's high energy needs, is critical for physiological pathways. Dysfunction in the mechanisms of energy production is at the center of neurological and neuropsychiatric pathologies. We examine the connections between energetics and mitochondria - the organelle responsible for almost all the energy production in the cell - and how secondary pathologies in traumatic brain injury result from energetic dysfunction. This paper interweaves these topics, a necessity since they are closely coupled, and identifies where there exist a lack of understanding and of data. In addition to summarizing current thinking in these disciplines, our goal is to suggest a framework for the mathematical modeling of mechanisms and pathways based on optimal energetic decisions.
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Affiliation(s)
- Haym Benaroya
- Department of Mechanical and Aerospace Engineering, Rutgers University, 98 Brett Road, Piscataway, NJ 08854, USA
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Hier DB, Obafemi-Ajayi T, Thimgan MS, Olbricht GR, Azizi S, Allen B, Hadi BA, Wunsch DC. Blood biomarkers for mild traumatic brain injury: a selective review of unresolved issues. Biomark Res 2021; 9:70. [PMID: 34530937 PMCID: PMC8447604 DOI: 10.1186/s40364-021-00325-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 08/26/2021] [Indexed: 01/03/2023] Open
Abstract
Background The use of blood biomarkers after mild traumatic brain injury (mTBI) has been widely studied. We have identified eight unresolved issues related to the use of five commonly investigated blood biomarkers: neurofilament light chain, ubiquitin carboxy-terminal hydrolase-L1, tau, S100B, and glial acidic fibrillary protein. We conducted a focused literature review of unresolved issues in three areas: mode of entry into and exit from the blood, kinetics of blood biomarkers in the blood, and predictive capacity of the blood biomarkers after mTBI. Findings Although a disruption of the blood brain barrier has been demonstrated in mild and severe traumatic brain injury, biomarkers can enter the blood through pathways that do not require a breach in this barrier. A definitive accounting for the pathways that biomarkers follow from the brain to the blood after mTBI has not been performed. Although preliminary investigations of blood biomarkers kinetics after TBI are available, our current knowledge is incomplete and definitive studies are needed. Optimal sampling times for biomarkers after mTBI have not been established. Kinetic models of blood biomarkers can be informative, but more precise estimates of kinetic parameters are needed. Confounding factors for blood biomarker levels have been identified, but corrections for these factors are not routinely made. Little evidence has emerged to date to suggest that blood biomarker levels correlate with clinical measures of mTBI severity. The significance of elevated biomarker levels thirty or more days following mTBI is uncertain. Blood biomarkers have shown a modest but not definitive ability to distinguish concussed from non-concussed subjects, to detect sub-concussive hits to the head, and to predict recovery from mTBI. Blood biomarkers have performed best at distinguishing CT scan positive from CT scan negative subjects after mTBI.
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Affiliation(s)
- Daniel B Hier
- Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO 65401, USA.
| | - Tayo Obafemi-Ajayi
- Cooperative Engineering Program, Missouri State University, Springfield, MO 65897, United States
| | - Matthew S Thimgan
- Department of Biological Sciences, Missouri University of Science and Technology, Rolla, MO 65409, United States
| | - Gayla R Olbricht
- Department of Mathematics and Statistics, Missouri University of Science and Technology, Rolla, MO 65409, United States
| | - Sima Azizi
- Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO 65401, USA
| | - Blaine Allen
- Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO 65401, USA
| | - Bassam A Hadi
- Department of Surgery, Mercy Hospital, St. Louis MO, Missouri, MO 63141, United States
| | - Donald C Wunsch
- Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO 65401, USA.,National Science Foundation, ECCS Division, Virginia, 22314, USA
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Azizi S, Hier DB, Allen B, Obafemi-Ajayi T, Olbricht GR, Thimgan MS, Wunsch DC. A Kinetic Model for Blood Biomarker Levels After Mild Traumatic Brain Injury. Front Neurol 2021; 12:668606. [PMID: 34295300 PMCID: PMC8289906 DOI: 10.3389/fneur.2021.668606] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/09/2021] [Indexed: 01/23/2023] Open
Abstract
Traumatic brain injury (TBI) imposes a significant economic and social burden. The diagnosis and prognosis of mild TBI, also called concussion, is challenging. Concussions are common among contact sport athletes. After a blow to the head, it is often difficult to determine who has had a concussion, who should be withheld from play, if a concussed athlete is ready to return to the field, and which concussed athlete will develop a post-concussion syndrome. Biomarkers can be detected in the cerebrospinal fluid and blood after traumatic brain injury and their levels may have prognostic value. Despite significant investigation, questions remain as to the trajectories of blood biomarker levels over time after mild TBI. Modeling the kinetic behavior of these biomarkers could be informative. We propose a one-compartment kinetic model for S100B, UCH-L1, NF-L, GFAP, and tau biomarker levels after mild TBI based on accepted pharmacokinetic models for oral drug absorption. We approximated model parameters using previously published studies. Since parameter estimates were approximate, we did uncertainty and sensitivity analyses. Using estimated kinetic parameters for each biomarker, we applied the model to an available post-concussion biomarker dataset of UCH-L1, GFAP, tau, and NF-L biomarkers levels. We have demonstrated the feasibility of modeling blood biomarker levels after mild TBI with a one compartment kinetic model. More work is needed to better establish model parameters and to understand the implications of the model for diagnostic use of these blood biomarkers for mild TBI.
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Affiliation(s)
- Sima Azizi
- Applied Computational Intelligence Laboratory, Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO, United States
| | - Daniel B Hier
- Applied Computational Intelligence Laboratory, Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO, United States
| | - Blaine Allen
- Applied Computational Intelligence Laboratory, Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO, United States
| | - Tayo Obafemi-Ajayi
- Engineering Program, Missouri State University, Springfield, MO, United States
| | - Gayla R Olbricht
- Department of Mathematics and Statistics, Missouri University of Science and Technology, Rolla, MO, United States
| | - Matthew S Thimgan
- Department of Biological Sciences, Missouri University of Science and Technology, Rolla, MO, United States
| | - Donald C Wunsch
- Applied Computational Intelligence Laboratory, Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO, United States.,ECCS Division, National Science Foundation, Alexandria, VA, United States
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11
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Bohnert S, Wirth C, Schmitz W, Trella S, Monoranu CM, Ondruschka B, Bohnert M. Myelin basic protein and neurofilament H in postmortem cerebrospinal fluid as surrogate markers of fatal traumatic brain injury. Int J Legal Med 2021; 135:1525-1535. [PMID: 33895854 PMCID: PMC8205912 DOI: 10.1007/s00414-021-02606-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/15/2021] [Indexed: 11/29/2022]
Abstract
The aim of this study was to investigate if the biomarkers myelin basic protein (MBP) and neurofilament-H (NF-H) yielded informative value in forensic diagnostics when examining cadaveric cerebrospinal fluid (CSF) biochemically via an enzyme-linked immunosorbent assay (ELISA) and comparing the corresponding brain tissue in fatal traumatic brain injury (TBI) autopsy cases by immunocytochemistry versus immunohistochemistry. In 21 trauma and 19 control cases, CSF was collected semi-sterile after suboccipital puncture and brain specimens after preparation. The CSF MBP (p = 0.006) and NF-H (p = 0.0002) levels after TBI were significantly higher than those in cardiovascular controls. Immunohistochemical staining against MBP and against NF-H was performed on cortical and subcortical samples from also biochemically investigated cases (5 TBI cases/5 controls). Compared to the controls, the TBI cases showed a visually reduced staining reaction against MBP or repeatedly ruptured neurofilaments against NF-H. Immunocytochemical tests showed MBP-positive phagocytizing macrophages in CSF with a survival time of > 24 h. In addition, numerous TMEM119-positive microglia could be detected with different degrees of staining intensity in the CSF of trauma cases. As a result, we were able to document that elevated levels of MBP and NF-H in the CSF should be considered as useful neuroinjury biomarkers of traumatic brain injury.
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Affiliation(s)
- Simone Bohnert
- Institute of Forensic Medicine, University of Wuerzburg, Versbacher Str. 3, 97078, Wuerzburg, Germany.
| | - Christoph Wirth
- Institute of Forensic Medicine, University of Wuerzburg, Versbacher Str. 3, 97078, Wuerzburg, Germany
| | - Werner Schmitz
- Institute of Biochemistry and Molecular Biology I, Biozentrum - Am Hubland, 97074, Wuerzburg, Germany
| | - Stefanie Trella
- Institute of Forensic Medicine, University of Wuerzburg, Versbacher Str. 3, 97078, Wuerzburg, Germany
| | - Camelia-Maria Monoranu
- Department of Neuropathology, Institute of Pathology, University of Wuerzburg, Josef-Schneider Str. 2, 97080, Wuerzburg, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany
| | - Michael Bohnert
- Institute of Forensic Medicine, University of Wuerzburg, Versbacher Str. 3, 97078, Wuerzburg, Germany
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12
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Farré-Alins V, Palomino-Antolín A, Narros-Fernández P, Lopez-Rodriguez AB, Decouty-Perez C, Muñoz-Montero A, Zamorano-Fernández J, Mansilla-Fernández B, Giner-García J, García-Feijoo P, Sáez-Alegre M, Palpán-Flores AJ, Roda-Frade JM, Carabias CS, Rosa JM, Civantos-Martín B, Yus-Teruel S, Gandía L, Lagares A, Hernández-García BJ, Egea J. Serum Amyloid A1/Toll-Like Receptor-4 Axis, an Important Link between Inflammation and Outcome of TBI Patients. Biomedicines 2021; 9:biomedicines9060599. [PMID: 34070533 PMCID: PMC8227125 DOI: 10.3390/biomedicines9060599] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/16/2023] Open
Abstract
Traumatic brain injury (TBI) is one of the leading causes of mortality and disability worldwide without any validated biomarker or set of biomarkers to help the diagnosis and evaluation of the evolution/prognosis of TBI patients. To achieve this aim, a deeper knowledge of the biochemical and pathophysiological processes triggered after the trauma is essential. Here, we identified the serum amyloid A1 protein-Toll-like receptor 4 (SAA1-TLR4) axis as an important link between inflammation and the outcome of TBI patients. Using serum and mRNA from white blood cells (WBC) of TBI patients, we found a positive correlation between serum SAA1 levels and injury severity, as well as with the 6-month outcome of TBI patients. SAA1 levels also correlate with the presence of TLR4 mRNA in WBC. In vitro, we found that SAA1 contributes to inflammation via TLR4 activation that releases inflammatory cytokines, which in turn increases SAA1 levels, establishing a positive proinflammatory loop. In vivo, post-TBI treatment with the TLR4-antagonist TAK242 reduces SAA1 levels, improves neurobehavioral outcome, and prevents blood–brain barrier disruption. Our data support further evaluation of (i) post-TBI treatment in the presence of TLR4 inhibition for limiting TBI-induced damage and (ii) SAA1-TLR4 as a biomarker of injury progression in TBI patients.
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Affiliation(s)
- Víctor Farré-Alins
- Molecular Neuroinflammation and Neuronal Plasticity Research Laboratory, Research Unit, Hospital Universitario Santa Cristina, Instituto de Investigación Sanitaria-Hospital Universitario de la Princesa, 28009 Madrid, Spain; (V.F.-A.); (A.P.-A.); (P.N.-F.); (A.B.L.-R.); (C.D.-P.); (J.M.R.)
- Instituto Teófilo Hernando, Departamento de Farmacología y Terapéutica, Facultad de Medicina, UAM, 28029 Madrid, Spain; (A.M.-M.); (L.G.)
| | - Alejandra Palomino-Antolín
- Molecular Neuroinflammation and Neuronal Plasticity Research Laboratory, Research Unit, Hospital Universitario Santa Cristina, Instituto de Investigación Sanitaria-Hospital Universitario de la Princesa, 28009 Madrid, Spain; (V.F.-A.); (A.P.-A.); (P.N.-F.); (A.B.L.-R.); (C.D.-P.); (J.M.R.)
- Instituto Teófilo Hernando, Departamento de Farmacología y Terapéutica, Facultad de Medicina, UAM, 28029 Madrid, Spain; (A.M.-M.); (L.G.)
| | - Paloma Narros-Fernández
- Molecular Neuroinflammation and Neuronal Plasticity Research Laboratory, Research Unit, Hospital Universitario Santa Cristina, Instituto de Investigación Sanitaria-Hospital Universitario de la Princesa, 28009 Madrid, Spain; (V.F.-A.); (A.P.-A.); (P.N.-F.); (A.B.L.-R.); (C.D.-P.); (J.M.R.)
- Instituto Teófilo Hernando, Departamento de Farmacología y Terapéutica, Facultad de Medicina, UAM, 28029 Madrid, Spain; (A.M.-M.); (L.G.)
| | - Ana Belen Lopez-Rodriguez
- Molecular Neuroinflammation and Neuronal Plasticity Research Laboratory, Research Unit, Hospital Universitario Santa Cristina, Instituto de Investigación Sanitaria-Hospital Universitario de la Princesa, 28009 Madrid, Spain; (V.F.-A.); (A.P.-A.); (P.N.-F.); (A.B.L.-R.); (C.D.-P.); (J.M.R.)
- Instituto Teófilo Hernando, Departamento de Farmacología y Terapéutica, Facultad de Medicina, UAM, 28029 Madrid, Spain; (A.M.-M.); (L.G.)
| | - Céline Decouty-Perez
- Molecular Neuroinflammation and Neuronal Plasticity Research Laboratory, Research Unit, Hospital Universitario Santa Cristina, Instituto de Investigación Sanitaria-Hospital Universitario de la Princesa, 28009 Madrid, Spain; (V.F.-A.); (A.P.-A.); (P.N.-F.); (A.B.L.-R.); (C.D.-P.); (J.M.R.)
- Instituto Teófilo Hernando, Departamento de Farmacología y Terapéutica, Facultad de Medicina, UAM, 28029 Madrid, Spain; (A.M.-M.); (L.G.)
| | - Alicia Muñoz-Montero
- Instituto Teófilo Hernando, Departamento de Farmacología y Terapéutica, Facultad de Medicina, UAM, 28029 Madrid, Spain; (A.M.-M.); (L.G.)
| | - Jorge Zamorano-Fernández
- Servicio de Neurocirugía, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.Z.-F.); (B.M.-F.); (J.G.-G.); (P.G.-F.); (M.S.-A.); (A.J.P.-F.); (J.M.R.-F.); (B.J.H.-G.)
| | - Beatriz Mansilla-Fernández
- Servicio de Neurocirugía, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.Z.-F.); (B.M.-F.); (J.G.-G.); (P.G.-F.); (M.S.-A.); (A.J.P.-F.); (J.M.R.-F.); (B.J.H.-G.)
| | - Javier Giner-García
- Servicio de Neurocirugía, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.Z.-F.); (B.M.-F.); (J.G.-G.); (P.G.-F.); (M.S.-A.); (A.J.P.-F.); (J.M.R.-F.); (B.J.H.-G.)
| | - Pablo García-Feijoo
- Servicio de Neurocirugía, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.Z.-F.); (B.M.-F.); (J.G.-G.); (P.G.-F.); (M.S.-A.); (A.J.P.-F.); (J.M.R.-F.); (B.J.H.-G.)
| | - Miguel Sáez-Alegre
- Servicio de Neurocirugía, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.Z.-F.); (B.M.-F.); (J.G.-G.); (P.G.-F.); (M.S.-A.); (A.J.P.-F.); (J.M.R.-F.); (B.J.H.-G.)
| | - Alexis J. Palpán-Flores
- Servicio de Neurocirugía, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.Z.-F.); (B.M.-F.); (J.G.-G.); (P.G.-F.); (M.S.-A.); (A.J.P.-F.); (J.M.R.-F.); (B.J.H.-G.)
| | - José María Roda-Frade
- Servicio de Neurocirugía, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.Z.-F.); (B.M.-F.); (J.G.-G.); (P.G.-F.); (M.S.-A.); (A.J.P.-F.); (J.M.R.-F.); (B.J.H.-G.)
| | - Cristina S. Carabias
- Servicio de Neurocirugía, Hospital Universitario 12 de Octubre, imas12, Universidad Complutense de Madrid, 28041 Madrid, Spain; (C.S.C.); (A.L.)
| | - Juliana M. Rosa
- Molecular Neuroinflammation and Neuronal Plasticity Research Laboratory, Research Unit, Hospital Universitario Santa Cristina, Instituto de Investigación Sanitaria-Hospital Universitario de la Princesa, 28009 Madrid, Spain; (V.F.-A.); (A.P.-A.); (P.N.-F.); (A.B.L.-R.); (C.D.-P.); (J.M.R.)
| | - Belén Civantos-Martín
- Servicio de Medicina Intensiva, Hospital Universitario La Paz, 28046 Madrid, Spain; (B.C.-M.); (S.Y.-T.)
| | - Santiago Yus-Teruel
- Servicio de Medicina Intensiva, Hospital Universitario La Paz, 28046 Madrid, Spain; (B.C.-M.); (S.Y.-T.)
| | - Luis Gandía
- Instituto Teófilo Hernando, Departamento de Farmacología y Terapéutica, Facultad de Medicina, UAM, 28029 Madrid, Spain; (A.M.-M.); (L.G.)
| | - Alfonso Lagares
- Servicio de Neurocirugía, Hospital Universitario 12 de Octubre, imas12, Universidad Complutense de Madrid, 28041 Madrid, Spain; (C.S.C.); (A.L.)
| | - Borja J. Hernández-García
- Servicio de Neurocirugía, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.Z.-F.); (B.M.-F.); (J.G.-G.); (P.G.-F.); (M.S.-A.); (A.J.P.-F.); (J.M.R.-F.); (B.J.H.-G.)
| | - Javier Egea
- Molecular Neuroinflammation and Neuronal Plasticity Research Laboratory, Research Unit, Hospital Universitario Santa Cristina, Instituto de Investigación Sanitaria-Hospital Universitario de la Princesa, 28009 Madrid, Spain; (V.F.-A.); (A.P.-A.); (P.N.-F.); (A.B.L.-R.); (C.D.-P.); (J.M.R.)
- Instituto Teófilo Hernando, Departamento de Farmacología y Terapéutica, Facultad de Medicina, UAM, 28029 Madrid, Spain; (A.M.-M.); (L.G.)
- Correspondence: ; Tel.: +34-915574402
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Edwards LA, Donnelly CG, Reed SM, Valberg S, Chigerwe M, Johnson AL, Finno CJ. Serum and cerebrospinal fluid phosphorylated neurofilament heavy protein concentrations in equine neurodegenerative diseases. Equine Vet J 2021; 54:290-298. [PMID: 33969539 DOI: 10.1111/evj.13452] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/05/2021] [Accepted: 04/01/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Currently, there is little information regarding the concentrations of phosphorylated neurofilament heavy protein (pNfH) in the serum and cerebrospinal fluid (CSF) of horses with neurodegenerative diseases. Specifically, pNfH concentrations have not yet been evaluated in horses with equine neuroaxonal dystrophy/equine degenerative myeloencephalopathy (eNAD/EDM). OBJECTIVES To determine pNfH concentrations using a commercial enzyme-linked immunosorbent assay (ELISA) in serum and CSF from control horses and horses with eNAD/EDM, cervical vertebral compressive myelopathy (CVCM) and Shivers. STUDY DESIGN Case-control study using biobanked samples from diseased horses and prospective or biobanked samples from control horses. METHODS The pNfH ELISA was performed on samples from horses diagnosed with eNAD/EDM (n = 64), CVCM (n = 26) and Shivers (n = 9) and 51 neurologically normal control horses. RESULTS Median and 95% confidence interval (CI) serum pNfH concentrations in control, CVCM, and eNAD/EDM horses were 0.08 ng/mL (0.07-0.15), 0.07 ng/mL (0.07-0.15) and 0.07 ng/mL (0.07-1.13), respectively. Serum pNfH concentrations were below the limit of detection (<0.07 ng/mL) for all Shivers horses. CSF pNfH concentrations in control, CVCM-, eNAD/EDM- and Shivers-affected horses were 1.26 ng/mL (1.06-1.5), 3.07 ng/mL (1.15-29.9), 1.78 ng/mL (1.5-2.28) and 1.39 ng/mL (0.74-3.89), respectively. CSF pNfH concentrations were significantly higher in CVCM (P = .001) and eNAD/EDM (P = .01) affected horses compared to control horses. Serum pNfH concentrations >1 ng/mL were significantly associated with eNAD/EDM (P = .01) with only 12% sensitivity but 99% specificity. CSF pNfH concentrations >3 ng/mL were significantly associated with CVCM (P = .0002), with 50% sensitivity and 86% specificity. MAIN LIMITATIONS A limited number of control horses tested were <1 year of age. CONCLUSIONS Serum pNfH concentrations are specifically increased (>1 ng/mL) in some horses with eNAD/EDM. Increased CSF pNfH concentrations (>3 ng/mL) can be observed with eNAD/EDM or CVCM.
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Affiliation(s)
- Lisa A Edwards
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Callum G Donnelly
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | | | - Stephanie Valberg
- Department of Large Animal Clinical Sciences, Mary Anne McPhail Equine Performance Center, Michigan State University, East Lansing, MI, USA
| | - Munashe Chigerwe
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Amy L Johnson
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
| | - Carrie J Finno
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
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14
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Bartnik-Olson BL, Alger JR, Babikian T, Harris AD, Holshouser B, Kirov II, Maudsley AA, Thompson PM, Dennis EL, Tate DF, Wilde EA, Lin A. The clinical utility of proton magnetic resonance spectroscopy in traumatic brain injury: recommendations from the ENIGMA MRS working group. Brain Imaging Behav 2021; 15:504-525. [PMID: 32797399 PMCID: PMC7882010 DOI: 10.1007/s11682-020-00330-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Proton (1H) magnetic resonance spectroscopy provides a non-invasive and quantitative measure of brain metabolites. Traumatic brain injury impacts cerebral metabolism and a number of research groups have successfully used this technique as a biomarker of injury and/or outcome in both pediatric and adult TBI populations. However, this technique is underutilized, with studies being performed primarily at centers with access to MR research support. In this paper we present a technical introduction to the acquisition and analysis of in vivo 1H magnetic resonance spectroscopy and review 1H magnetic resonance spectroscopy findings in different injury populations. In addition, we propose a basic 1H magnetic resonance spectroscopy data acquisition scheme (Supplemental Information) that can be added to any imaging protocol, regardless of clinical magnetic resonance platform. We outline a number of considerations for study design as a way of encouraging the use of 1H magnetic resonance spectroscopy in the study of traumatic brain injury, as well as recommendations to improve data harmonization across groups already using this technique.
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Affiliation(s)
| | - Jeffry R Alger
- Departments of Neurology and Radiology, University of California Los Angeles, Los Angeles, CA, USA
- NeuroSpectroScopics LLC, Sherman Oaks, Los Angeles, CA, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
| | - Ashley D Harris
- Department of Radiology, University of Calgary, Calgary, Canada
- Child and Adolescent Imaging Research Program, Alberta Children's Hospital Research Institute and the Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Barbara Holshouser
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Ivan I Kirov
- Bernard and Irene Schwartz Center for Biomedical Imaging, Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Andrew A Maudsley
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
- Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, USC, Los Angeles, CA, USA
| | - Emily L Dennis
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Boston, MA, USA
| | - David F Tate
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Alexander Lin
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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15
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Zhou F, Zhan J, Gong T, Xu W, Kuang H, Li J, Wang Y, Gong H. Characterizing Static and Dynamic Fractional Amplitude of Low-Frequency Fluctuation and its Prediction of Clinical Dysfunction in Patients with Diffuse Axonal Injury. Acad Radiol 2021; 28:e63-e70. [PMID: 32204986 DOI: 10.1016/j.acra.2020.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/27/2020] [Accepted: 02/13/2020] [Indexed: 12/24/2022]
Abstract
RATIONALE AND OBJECTIVES Recently, advanced magnetic resonance imaging has been widely adopted to investigate altered structure and functional activities in patients with diffuse axonal injury (DAI), this patient presumed to be caused by shearing forces and results in significant neurological effects. However, little is known regarding cerebral temporal dynamics and its predictive ability in the clinical dysfunction of DAI. MATERIALS AND METHODS In this study, static and dynamic fractional amplitude of low-frequency fluctuation (fALFF), an improved approach to detect the intensity of intrinsic neural activities, and their temporal variability were applied to examine the alteration between DAI patients (n = 24) and healthy controls (n = 26) at the voxel level. Then, the altered functional index was used to explore the clinical relationship and predict dysfunction in DAI patients. RESULTS We discovered that, compared to healthy controls, DAI patients showed commonly altered regions of static fALFF, and its variability was mainly located in the left cerebellum posterior lobe. Furthermore, decreased static fALFF values over the left cerebellum posterior lobe and bilateral medial frontal gyrus showed significant correlations with disease duration and Mini-Mental State Examination scores. More important, the increased temporal variability of dynamic fALFF in the left caudate could predict the severity of the Glasgow Coma Scale score in DAI patients. CONCLUSION Overall, these results suggested selective abnormalities in intrinsic neural activities with reduced intensity and increased variability, and this novel predictive marker may be developed as a useful indicator for future connectomics or artificial intelligence analyses.
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Affiliation(s)
- Fuqing Zhou
- Department of Radiology, The People's Hospital of Yichun City, Yichun, 336000, People's Republic of China; Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China; Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China.
| | - Jie Zhan
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China; Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China
| | - Tao Gong
- Department of Radiology, The People's Hospital of Yichun City, Yichun, 336000, People's Republic of China
| | - Wenhua Xu
- Department of Orthopedics & Traumatology, The People's Hospital of Yichun City, Yichun, People's Republic of China
| | - Hongmei Kuang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China; Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China
| | - Jian Li
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China; Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China
| | - Yinhua Wang
- Department of Radiology, The People's Hospital of Yichun City, Yichun, 336000, People's Republic of China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China; Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China
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16
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Alexiou GA, Voulgaris S. The role of biomarkers for the management of mild traumatic brain injury. Clin Neurol Neurosurg 2020; 193:105845. [DOI: 10.1016/j.clineuro.2020.105845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
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17
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Liang Y, Tong F, Zhang L, Zhu L, Li W, Huang W, Zhao S, He G, Zhou Y. iTRAQ-based proteomic analysis discovers potential biomarkers of diffuse axonal injury in rats. Brain Res Bull 2019; 153:289-304. [PMID: 31539556 DOI: 10.1016/j.brainresbull.2019.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 08/19/2019] [Accepted: 09/13/2019] [Indexed: 12/13/2022]
Abstract
Diffuse axonal injury (DAI) is one of the most common and severe pathological consequences of traumatic brain injury (TBI). The molecular mechanism of DAI is highly complicated and still elusive, yet a clear understanding is crucial for the diagnosis, treatment, and prognosis of DAI. In our study, we used rats to establish a DAI model and applied isobaric tags for relative and absolute quantitation (iTRAQ) coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis to identify differentially expressed proteins (DEPs) in the corpus callosum. As a result, a total of 514 proteins showed differential expression between the injury groups and the control. Among these DEPs, 14 common DEPs were present at all seven time points postinjury (1, 3, 6, 12, 24, 48, and 72 h). Next, bioinformatic analysis was performed to elucidate the pathogenesis of DAI, which was found to possibly involve calcium ion-regulatory proteins (e.g., calsenilin and ryanodine receptor 2), cytoskeleton organization (e.g., peripherin, NFL, NFM, and NFH), apoptotic processes (e.g., calsenilin and protein kinase C delta type), and inflammatory response proteins (e.g., complement C3 and C-reactive protein). Moreover, peripherin and calsenilin were successfully confirmed by western blotting to be significantly upregulated during DAI, and immunohistochemical (IHC) analysis revealed that their expression increased and could be observed in axons after injury, thus indicating their potential as DAI biomarkers. Our experiments not only provide insight into the molecular mechanisms of axonal injury in rats during DAI but also give clinicians and pathologists important reference data for the diagnosis of DAI. Our findings may expand the list of DAI biomarkers and improve the postmortem diagnostic rate of DAI.
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Affiliation(s)
- Yue Liang
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Fang Tong
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Lin Zhang
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Longlong Zhu
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Wenhe Li
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China.
| | - Weisheng Huang
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Shuquan Zhao
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Guanglong He
- Institute of Forensic Science, Ministry of Public Security People's Republic of China, No. 17 Nanli Mulidi, Beijing, 100038, PR China.
| | - Yiwu Zhou
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
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18
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Cognitive Reserve Protects Against Memory Decrements Associated With Neuropathology in Traumatic Brain Injury. J Head Trauma Rehabil 2019; 34:E57-E65. [PMID: 30829821 DOI: 10.1097/htr.0000000000000472] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate whether cognitive reserve (CR) moderates the relationship between neuropathology and cognitive outcomes after traumatic brain injury (TBI). SETTING Outpatient research organization. PARTICIPANTS Patients with complicated mild (n = 8), moderate (n = 9), and severe (n = 44) TBI. DESIGN Prospective, cross-sectional study. MAIN MEASURES Cognitive reserve was estimated using a test of word reading (Wechsler Test of Adult Reading). Diffusion tensor imaging (functional anisotropy) was used to quantify neuropathology. Neuropsychological test scores were submitted to principal components analyses to create cognitive composites for memory, attention, executive function, and processing speed domains. RESULTS At lower levels of neuropathology, people with higher CR exhibited better memory than those with lower CR. This benefit diminished as neuropathology increased and disappeared at the highest levels of neuropathology. Cognitive reserve ceased exerting a protective effect at premorbid intelligence levels below average. CONCLUSION Cognitive reserve may differentially protect some cognitive domains against neuropathology relative to others. A clinical cutoff below which CR is no longer protective, together with a possible neuropathology ceiling effect, may be instructive for prognostication and clinical decision-making in cognitive rehabilitation.
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