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Review
. 2013 Aug;19(8):556-65.
doi: 10.1111/cns.12127. Epub 2013 May 27.

Biomarkers for the clinical differential diagnosis in traumatic brain injury--a systematic review

Shoji Yokobori  1 , Khadil Hosein, Stephen Burks, Ishna Sharma, Shyam Gajavelli, Ross Bullock
Affiliations
Review

Biomarkers for the clinical differential diagnosis in traumatic brain injury--a systematic review

Shoji Yokobori et al. CNS Neurosci Ther. 2013 Aug.

Abstract

Rapid triage and decision-making in the treatment of traumatic brain injury (TBI) present challenging dilemma in "resource poor" environments such as the battlefield and developing areas of the world. There is an urgent need for additional tools to guide treatment of TBI. The aim of this review is to establish the possible use of diagnostic TBI biomarkers in (1) identifying diffuse and focal brain injury and (2) assess their potential for determining outcome, intracranial pressure (ICP), and responses to therapy. At present, there is insufficient literature to support a role for diagnostic biomarkers in distinguishing focal and diffuse injury or for accurate determination of raised ICP. Presently, neurofilament (NF), S100β, glial fibrillary acidic protein (GFAP), and ubiquitin carboxyl terminal hydrolase-L1 (UCH-L1) seemed to have the best potential as diagnostic biomarkers for distinguishing focal and diffuse injury, whereas C-tau, neuron-specific enolase (NSE), S100β, GFAP, and spectrin breakdown products (SBDPs) appear to be candidates for ICP reflective biomarkers. With the combinations of different pathophysiology related to each biomarker, a multibiomarker analysis seems to be effective and would likely increase diagnostic accuracy. There is limited research focusing on the differential diagnostic properties of biomarkers in TBI. This fact warrants the need for greater efforts to innovate sensitive and reliable biomarkers. We advocate awareness and inclusion of the differentiation of injury type and ICP elevation in further studies with brain injury biomarkers.

Keywords: Biomarkers; Differential diagnosis; Intracranial hypertension; Pathophysiology; Traumatic brain injury.

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Conflict of interest statement

Dr Shoji Yokobori has been supported by The General Insurance Association of Japan (2012‐2013). Dr Bullock is a consultant and research collaborator with Banyan Biomarkers, inc 3. No author has received financial or other compensation in relation to this publication.

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References

    1. Langlois JA, Marr A, Mitchko J, Johnson RL. Tracking the silent epidemic and educating the public: CDC's traumatic brain injury‐associated activities under the TBI Act of 1996 and the Children's Health Act of 2000. J Head Trauma Rehabil 2005;20:196–204. - PubMed
    1. Binder S, Corrigan JD, Langlois JA. The public health approach to traumatic brain injury: An overview of CDC's research and programs. J Head Trauma Rehabil 2005;20:189–195. - PubMed
    1. Fu ES, Tummala RP. Neuroprotection in brain and spinal cord trauma. Curr Opin Anaesthesiol 2005;18:181–187. - PubMed
    1. Vink R, Nimmo AJ. Multifunctional drugs for head injury. Neurotherapeutics 2009;6:28–42. - PMC - PubMed
    1. Guidelines for the management of severe traumatic brain injury. J Neurotrauma 2007;24(Suppl 1):S1–S106. - PubMed

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