Citation

Deepika A, Devi BI, Shukla DP, Sathyaprabla TN, Christopher R, Ramesh SS. J. Neurotrauma 2018; 35(10): 1124-1131.

Affiliation

NIMHANS, Neurochemistry, bangalore, India ; shruthisr124@gmail.com.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5151

PMID

29304719

Abstract

The purpose of the present study is to evaluate the inter-dependency between the electrophysiological (Heart rate variability) and inflammatory markers in traumatic brain injury (TBI) patients and the outcome in patients with severe TBI. A prospective exploratory study was done with a sample size of 89 severe traumatic brain injury patients. The Heart rate variability of these patients was recorded using a telemetric device BioHarness® (Zephyr technologies). The recordings were made on day 1 of the patients' admission into the ICU followed by serial recordings on Day 3 and day 10. Serum samples of the patients were also collected on these days. They were analyzed for the IL-1β, IL-6, IL-10 and TNF-α using ELISA kits. The outcome assessment was done based on Disability Rating Scale (DRS) values at discharge and Glasgow Outcome Scale Extended (GOSE) values observed at the sixth month post trauma. The data set was analysed by grouping the patients on the basis of mortality and their outcome. In the present study, it was evidenced that there was significant subclinical autonomic dysfunction in patients with severe TBI. Among the serum cytokines, the levels of IL-10 had significant impact on the outcome. An increase in its levels correlated with the unfavorable outcome. This study highlights the association between the HRV parameters and the immune response. The timely management of both autonomic and immune dysfunction in the patients of severe TBI can have a greater impact in preventing the secondary injury process.

Language: en

Keywords

ADULT BRAIN INJURY; HUMAN STUDIES; INFLAMMATION; Other