Serum Neuron-specific Enolase as a Predictor of Short-term Outcome in Children with Closed Traumatic Brain Injury

Bandyopadhyay, Sivaji; Hennes, Halim; Gorelick, Marc H.; Wells, Robert G.; Walsh‐Kelly, Christine M.

doi:10.1111/j.1553-2712.2005.tb00940.x

Cited by 38 publications

(30 citation statements)

References 45 publications

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“…Moreover, NSE levels were strongly predictive of either death (sensitivity 85%) or poor outcome (sensitivity 80%) 6 months post-injury (Vos et al, 2004). Similarly, in 90 pediatric patients who experienced closed-head TBI, serum NSE predicted poor outcomes with 86% sensitivity and 74% specificity (Guzel et al, 2008; Bandyopadhyay et al, 2005). Severe and moderate TBI patient serum NSE levels (81.3 and 54.52 ng/ml, respectively) have also been shown to strongly correlate with typical neurological exams used to assess the degree of brain injury (Guzel et al, 2008; Meric et al, 2010).…”

Section: Serological Biomarkers For Brain Injurymentioning

confidence: 99%

Blood biomarkers for brain injury: What are we measuring?

Kawata

Liu

Merkel

et al. 2016

Neuroscience & Biobehavioral Reviews

198

168

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Accurate diagnosis for mild traumatic brain injury (mTBI) remains challenging, as prognosis and return-to-play/work decisions are based largely on patient reports. Numerous investigations have identified and characterized cellular factors in the blood as potential biomarkers for TBI, in the hope that these factors may be used to gauge the severity of brain injury. None of these potential biomarkers have advanced to use in the clinical setting. Some of the most extensively studied blood biomarkers for TBI include S100β, neuron-specific enolase, glial fibrillary acidic protein, and Tau. Understanding the biological function of each of these factors may be imperative to achieve progress in the field. We address the basic question: what are we measuring? This review will discuss blood biomarkers in terms of cellular origin, normal and pathological function, and possible reasons for increased blood levels. Considerations in the selection, evaluation, and validation of potential biomarkers will also be addressed, along with mechanisms that allow brain-derived proteins to enter the bloodstream after TBI. Lastly, we will highlight perspectives and implications for repetitive neurotrauma in the field of blood biomarkers for brain injury.

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Section: Serological Biomarkers For Brain Injurymentioning

confidence: 99%

Blood biomarkers for brain injury: What are we measuring?

Kawata

Liu

Merkel

et al. 2016

Neuroscience & Biobehavioral Reviews

198

168

View full text Add to dashboard Cite

show abstract

“…Therefore, the studies which have evaluated serum rather than cerebrospinal biomarkers are most relevant to clinical practice [12,13,14,15,16,17,18,19,20,21,22,23,24,25]. Although the adult literature is much more extensive than the pediatric literature, six pediatric studies have been published which evaluate the ability of biomarkers to predict outcome after TBI [20,21,22,23,24,26]. Other than a recent study by Topjian et al [25], we are unaware of any studies which have evaluated the use of biomarkers to predict outcome after HIE outside of the newborn period.…”

Section: Introductionmentioning

confidence: 99%

Trajectory Analysis of Serum Biomarker Concentrations Facilitates Outcome Prediction after Pediatric Traumatic and Hypoxemic Brain Injury

Berger

Bazaco

Wagner³

et al. 2010

Dev Neurosci

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Traumatic brain injury (TBI) and hypoxic ischemic encephalopathy (HIE) are leading causes of morbidity and mortality in children. Several studies over the past several years have evaluated the use of serum biomarkers to predict outcome after pediatric brain injury. These studies have all used simple point estimates such as initial and peak biomarker concentrations to predict outcome. However, this approach does not recognize patterns of change over time. Trajectory analysis is a type of analysis which can capture variance in biomarker concentrations over time and has been used with success in the social sciences. We used trajectory analysis to evaluate the ability of the serum concentrations of 3 brain-specific biomarkers – S100B, neuron-specific enolase (NSE) and myelin basic protein (MBP) – to predict poor outcome (Glasgow Outcome Scale scores 3–5) after pediatric TBI and HIE. Clinical and biomarker data from 100 children with TBI or HIE were evaluated. For each biomarker, we validated 2-, 3- and 4-group models for outcome prediction, using sensitivity and specificity. For S100B, the 3-group model predicted poor outcome with a sensitivity of 59% and specificity of 100%. For NSE, the 3-group model predicted poor outcome with a sensitivity of 48% and specificity of 98%. For MBP, the 3-group model predicted poor outcome with a sensitivity of 73% and specificity of 61%. Thus, when the models predicted a poor outcome, there was a very high probability of a poor outcome. In contrast, 17% of subjects with a poor outcome were predicted to have a good outcome by all 3 biomarker trajectories. These data suggest that trajectory analysis of biomarker data may provide a useful approach for predicting outcome after pediatric brain injury.

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“…It has been hypothesized that a combination of serum biomarkers or a combination of biomarkers and injury severity would most likely be the best predictors of outcome [21]. NSE has been shown to relate to global outcome using the Glasgow Outcome Scale (a five point scale assessing physical disability) [18–20], but sNCAM has not been previously studied in relation to outcome following paediatric TBI. In a related study, we investigated nine serum biomarkers and their relations to the inattention content scale of the Conners-3 measured 12 months after TBI.…”

Section: Discussionmentioning

confidence: 99%

Brain biomarkers and pre-injury cognition are associated with long-term cognitive outcome in children with traumatic brain injury

et al. 2017

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BackgroundChildren with traumatic brain injury (TBI) are frequently at risk of long-term impairments of attention and executive functioning but these problems are difficult to predict. Although deficits have been reported to vary with injury severity, age at injury and sex, prognostication of outcome remains imperfect at a patient-specific level. The objective of this proof of principle study was to evaluate a variety of patient variables, along with six brain-specific and inflammatory serum protein biomarkers, as predictors of long-term cognitive outcome following paediatric TBI.MethodOutcome was assessed in 23 patients via parent-rated questionnaires related to attention deficit hyperactivity disorder (ADHD) and executive functioning, using the Conners 3rd Edition Rating Scales (Conners-3) and Behaviour Rating Inventory of Executive Function (BRIEF) at a mean time since injury of 3.1 years. Partial least squares (PLS) analyses were performed to identify factors measured at the time of injury that were most closely associated with outcome on (1) the Conners-3 and (2) the Behavioural Regulation Index (BRI) and (3) Metacognition Index (MI) of the BRIEF.ResultsHigher levels of neuron specific enolase (NSE) and lower levels of soluble neuron cell adhesion molecule (sNCAM) were associated with higher scores on the inattention, hyperactivity/impulsivity and executive functioning scales of the Conners-3, as well as working memory and initiate scales of the MI from the BRIEF. Higher levels of NSE only were associated with higher scores on the inhibit scale of the BRI.ConclusionsNSE and sNCAM show promise as reliable, early predictors of long-term attention-related and executive functioning problems following paediatric TBI.

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Serum Neuron-specific Enolase as a Predictor of Short-term Outcome in Children with Closed Traumatic Brain Injury

Abstract: It appears that the serum NSE level can be used as a predictor of global short-term physical disability in children following cTBI.

Cited by 38 publications

References 45 publications

Blood biomarkers for brain injury: What are we measuring?

Blood biomarkers for brain injury: What are we measuring?

Trajectory Analysis of Serum Biomarker Concentrations Facilitates Outcome Prediction after Pediatric Traumatic and Hypoxemic Brain Injury

Brain biomarkers and pre-injury cognition are associated with long-term cognitive outcome in children with traumatic brain injury

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