Swaney Ella E K, Cai Tengyi, Seal Marc L, Ignjatovic Vera
Department of Haematology, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
Front Neurol. 2023 Feb 28;14:989974. doi: 10.3389/fneur.2023.989974. eCollection 2023.
Blood biomarkers have been identified as an alternative tool for predicting secondary outcomes following concussion. This systematic review aimed to summarize the literature on blood biomarkers of secondary outcomes following concussion in both pediatric and adult cohorts.
A literature search of Embase, Medline and PubMed was conducted. Two reviewers independently assessed retrieved studies to determine inclusion in systematic review synthesis.
A total of 1771 unique studies were retrieved, 58 of which were included in the final synthesis. S100B, GFAP and tau were identified as being associated with secondary outcomes following concussion. Seventeen percent of studies were performed in a solely pediatric setting.
Validation of biomarkers associated with secondary outcomes following concussion have been largely limited by heterogeneous study cohorts and definitions of concussion and mTBI, presenting a hurdle for translation of these markers into clinical practice. Additionally, there was an underrepresentation of studies which investigated pediatric cohorts. Adult markers are not appropriate for children, therefore pediatric specific markers of secondary outcomes following concussion present the biggest gap in this field.
血液生物标志物已被确定为预测脑震荡后次要结局的一种替代工具。本系统评价旨在总结关于儿童和成人队列脑震荡后次要结局血液生物标志物的文献。
对Embase、Medline和PubMed进行文献检索。两名评价者独立评估检索到的研究,以确定是否纳入系统评价综合分析。
共检索到1771项独特研究,其中58项纳入最终综合分析。S100B、胶质纤维酸性蛋白(GFAP)和tau被确定与脑震荡后次要结局相关。17%的研究仅在儿科环境中进行。
与脑震荡后次要结局相关的生物标志物的验证在很大程度上受到研究队列异质性以及脑震荡和轻度创伤性脑损伤(mTBI)定义的限制,这为将这些标志物转化为临床实践带来了障碍。此外,研究儿科队列的研究占比不足。成人标志物不适用于儿童,因此脑震荡后次要结局的儿科特异性标志物是该领域最大的差距所在。