Citation

Shan R, Szmydynger-Chodobska J, Warren OU, Zink BJ, Mohammad F, Chodobski A. J. Neurotrauma 2015; 33(1): 49-57.

Affiliation

Alpert Medical School of Brown University, Emergency Medicine, Providence, Rhode Island, United States ; rongzi_shan@alumni.brown.edu.

Copyright

(Copyright © 2015, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2014.3811

PMID

25794137

Abstract

No routine tests currently exist to objectively diagnose mild traumatic brain injury (mTBI)/concussion. Previously reported biomarkers for mTBI represented proteins released from the damaged neurons or glia. However, the low levels of these proteins and/or the complexity of assays used for their detection limits the implementation of these biomarkers in routine practice. Here we sought to identify proteins whose synthesis is altered after mTBI and whose blood levels could be measured using standard immunoassays. Adult patients sustaining a concussion within the past 24 h were enrolled. Controls were uninjured subjects and patients with orthopedic injury (OI). Four candidate biomarkers were identified: copeptin, galectin 3 (LGALS3), matrix metalloproteinase 9 (MMP9), and occludin (OCLN). A 3.4-fold decrease (p<0.0001) in plasma concentration of copeptin was found in mTBI patients within 8 h after accident compared to uninjured controls. Plasma levels of GALS3, MMP9, and OCLN increased 3.6-4.5-fold (p<0.0001) within the same time frame post-injury. The levels of at least two biomarkers were altered beyond their respective cutoff values in 90% of mTBI patients, whereas in none of uninjured controls, were the levels of two biomarkers simultaneously changed. A positive correlation (r=0.681, p<0.001) between the plasma levels of LGALS3 and OCLN was also found in mTBI patients, whereas in OI patients or uninjured subjects, these variables did not correlate. This panel of biomarkers discerns with high accuracy patients with isolated concussion from uninjured individuals within the first 8 h after accident. These biomarkers can also aid in diagnosing concussion in the presence of OI.

Language: en