Approximately 28,000 service members (SMs) sustain a traumatic brain injury (TBI) each year in the U.S. military. The majority of the injuries result either in a brief or no loss of consciousness, and are classified as a mild TBI (mTBI or concussion). Current evaluation guidelines of SMs suspected of having a mTBI rely heavily on self-reports. However, there is concern that SMs typically minimize or do not report their symptoms of mTBI for fear that doing so will result in being removed from the battlefield. Because mTBI often results in headaches, cognitive dysfunction, attention difficulties, and balance problems, returning to the battlefield before resolution of their symptoms can be dangerous for the SM and for their unit. Sustaining a second concussion before resolution of a previous mTBI also may make long-term neuronal injury more likely. The mTBI Diagnostics Workshop was designed as a forum where civilian and military experts from a variety of TBI-related clinical and basic science discip...

Proceedings of the military mTBI Diagnostics Workshop, St. Pete Beach, August 2010.

The present invention identifies biomarkers that are diagnostic of nerve cell injury and/or neuronal disorders. Detection of different biomarkers of the invention are also diagnostic of the degree of severity of nerve injury, the cell(s) involved in the injury, and the subcellular localization of the injury.

Neural proteins as biomarkers for nervous system injury and other neural disorders

Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcome prediction among mild-to-moderate head injury patients Materials and Methods It was a prospective study done at the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University from Jan 2018 to July 2019 All patients who presented to us within 48 hours of injury with mild-to-moderate head injury with apparently normal CT brain were include in the study The serum sample were collected on the day of admission and 48 hours later, and patients were treated with standard protocols and observed 6 months postdischarge Results Of the 32 patients enrolled, we observed mean MBP level was higher for severity of brain damage, but not associated with age, mode of injury, and radiological diagnosis Mean MBP levels were not statistically associated with Glasgow coma scale (GCS) score at admission but was correlated to outcome with p Conclusion MBP as per our analysis can be used as a prognostic marker in patients with head injury It is not the absolute value rather a trend showing rise in serum MBP levels, which carries a significant value in outcome prediction

/pdf/serum-concentration-of-myelin-basic-protein-as-a-prognostic-3jhv0no7x8.pdf

Serum Concentration of Myelin Basic Protein as a Prognostic Marker in Mild-to-moderate Head Injury Patients: A Prospective Study in a Tertiary Care Center

Introduction: Prognosis in Traumatic Brain Injury (TBI) can be made using prognostic models (the IMPACT and CRASH models) or brain injury biomarkers (S100B). Current prognostic models are derived from historic datasets recruited from heterogeneous countries in terms of trauma care and for the purpose of clinical trials. Objective: To construct a prognostic model suitable for British trauma care, to compare the prognostic performance of prognostic models with S100B and to assess the combination of prognosticators from the constructed models with S100B. Methods: A dataset of 802 TBI cases from the Trauma Audit and Research Network (TARN), Manchester, UK was used to construct the prognostic models.. During the modelling, criteria for well-developed models as per the literature review were followed such as the dataset being large, the variables being selected from the literature and missing information being imputed. A further dataset of TBI cases was used to validate these models Moreover, the resulting models were run on a dataset of 100 TBI cases who had their serum S100B recorded at 24 hours to compare their performance with S100B. Results: Two prognostic models were constructed (models A and B) to predict the discharge survival. Both models share age, admission Glasgow Coma Scale (GCS), admission pupillary reactivity and presence/absence of hypoxia and lowblood pressure (on admission) and brain stem injury. However, model A includes Injury Severity Score (ISS) which is replaced with cause of injury, extracranial injury, brain swelling and interaction of cause of injury and age in model B. Both models have high performance either on the derivation dataset (Area Under the ROC Curve (AUC) of model A: 0.92 and AUC of model B: 0.93) or the external validation set from a later time period in TARN (AUC of model A: 0.92 and AUC of model B: 0.82). Furthermore, in the S100B dataset, it appears that the performance of prognostic models is not significantly different to that of S100B (for example, AUC of model A in this dataset: 0.64 versus 0.69 of the model just including S100B for survival prediction). A combination of S100B and models prognosticators improved performance and S100 improved the performance of models A and B. Discussion: The proposed prognostic models have very high AUCs and since they have been validated on a different TBI dataset from TARN, they are valid to be used for the purpose of the British trauma care benchmarking. Unfortunately, the results of the analysis on the small S100B dataset are not adequately powerful to be conclusive. However, these findings highlight the importance of future research on this topic in larger datasets. Conclusion: Two prognostic models have been constructed which can be used for the British TBI patients.

Prognosis in traumatic brain injury (TBI)

Acute brain injury as a result of stroke and traumatic brain injury are leading causes of disability and mortality Methods to improve patient diagnosis and prognosis for these common conditions are needed Molecular biomarkers are one method that has been evaluated to diagnose acute brain injury, determine its cause, and predict outcomes and response to therapy Markers that have been identified include a variety of proteins, nucleic acids, and lipids that relate to the pathophysiology of acute brain injury Inflammation plays an important role in acute brain injury and several molecules involved in inflammation have been identified as biomarkers However, biomarkers for acute brain injury is a developing field that requires additional study is to identify markers for use in clinical practice These studies will include evaluating a larger number of candidate markers using proteomic, genomic, metabolomic, and lipidomic approaches Additionally, novel markers such as microRNA and the use of panels that integrate multiple markers may also prove to be valuable tools in acute brain injury In this chapter, we provide a summary of identified inflammatory biomarkers in acute brain injury, and how these biomarkers could add to patient care

Inflammatory Biomarkers in Patients with Acute Brain Injuries

Serum levels of myelin basic protein (MBP) were measured in 112 patients after acute head injury by enzyme linked immuno-absorbent assay (ELISA). Patients with cerebral concussion showed no significant change in serum MBP. Patients with cerebral contusion, extradural hematoma or intracerebral hematoma had a mean serum MBP concentration much higher than that of patients with cerebral concussion. And patients with extradural hematoma had a mean serum MBP concentration much lower than that of patients with cerebral contusion and intracerebral hematoma; the differences were significant (P 0.05). The amount of serum MBP was significantly correlated with the volume of extradural hematoma, intracerebral hematoma and with the extent of the cerebral contusion (P < 0.05). This study suggested that the serum MBP may reflect the type and severity of closed head injury patients.

The value of serum myelin basic protein in assessment of severity of acute closed head trauma

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The value of serum myelin basic protein in assessment of severity of acute closed head trauma