Citation

Goyal A, Carter M, Niyonkuru C, Fabio A, Amin K, Berger RP, Wagner AK. J. Neurotrauma 2013; 30(11): 946-957.

Affiliation

University of Pittsburgh, Physical Medicine & Rehabilitation, Kaufamann Medical Bldg., Suite 201, 3471 Fifthe Ave., Pittsburgh, Pennsylvania, United States, 15213; akg25@pitt.edu.

Copyright

(Copyright © 2013, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2012.2579

PMID

23190274

Abstract

As an astrocytic protein specific to the central nervous system (CNS), S100b is a potentially useful marker in outcome prediction after traumatic brain injury (TBI). Some studies have questioned the validity of S100b, citing the extra-cerebral origins of the protein as reducing the specificity of the marker. This study evaluated S100b as a prognostic biomarker in adult subjects with severe TBI by comparing outcomes with S100b temporal profiles generated from both cerebrospinal fluid (CSF) (n=138 subjects) and serum (n=80 subjects) samples across a six-day time-course. Long bone fracture, injury severity score (ISS), and isolated head injury status were variables used to assess extra-cerebral sources of S100b in serum. After TBI, CSF and serum S100b levels were increased over healthy controls across the first 6 days post-TBI (p≤0.005 and p≤0.031). While CSF and serum levels were highly correlated during early time points post-TBI, this association disappeared over time. Bivariate analysis showed that subjects who had temporal CSF profiles with higher S100b concentrations had higher acute mortality (p<0.001) and with worse Glasgow Outcome Scale (GOS) scores (p=0.002) and Disability Rating Scale (DRS) scores (p=0.039) 6 months post-injury. It is possible that, due to extra-cerebral sources of S100b in serum as represented by high ISS scores (p=0.032), temporal serum profiles were associated with acute mortality (p=0.015). High CSF S100b levels were observed in women (p=0.022) and older subjects (p=0.004). Multivariate logistic regression confirmed CSF S100b profiles in predicting GOS and DRS and showed mean and peak serum S100b as acute mortality predictors following severe TBI.

Language: en