Mayer Andrew R, Wick Tracey V, McQuaid Jessica R, Boucher Masen L, Dodd Andrew B, Robertson-Benta Cidney R, van der Horn Harm J, Erhardt Erik B, Sapien Robert E, Tarawneh Rawan, Mannix Rebekah
The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, 87106, USA.
Departments of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, 87131, USA.
Sci Rep. 2025 Feb 4;15(1):4189. doi: 10.1038/s41598-024-84053-4.
Pediatric mild traumatic brain injury (pmTBI) affects millions of youth annually but underlying pathophysiology and time for physiological recovery remains unknown. Non-fasting plasma samples were obtained in 59 pmTBI (28 females; age 14.9 ± 2.7) at approximately 7 days and 4 months post-injury and in 41 matched healthy controls (HC: 20 females; age 14.3 ± 2.8). Samples were analyzed for GFAP, NFL, Tau, pTau181 and UCH-L1 protein concentrations in conjunction with a clinical battery. Significant effects of diagnosis (pmTBI > HC) existed at ~ 7 days (p < 0.001; Cohen's d = 0.72) and ~ 4 months (p = 0.015; Cohen's d = 0.41) post-injury for NFL. NFL was also elevated in pmTBI with significant alterations to mental status (e.g., post-traumatic amnesia) relative to patients without (p = 0.014; Cohen's d = 0.77). UCH-L1, GFAP and pTau181 did not differ between groups, but demonstrated negative associations with days post-injury (small to medium effect sizes) suggestive of a more rapid release/clearance. Post-concussive symptoms had the best diagnostic classification accuracy at ~ 7 days, but NFL ranked higher at 4 months post-injury. Preliminary findings highlight dynamic fluctuations in blood-based biomarkers in the first week of pmTBI, with ongoing evidence of protein release (NFL) at 4 months. NFL demonstrated additional promise for delineating injury severity within the spectrum of pmTBI.
小儿轻度创伤性脑损伤（pmTBI）每年影响数百万青少年，但潜在的病理生理学和生理恢复时间仍不清楚。在59名pmTBI患者（28名女性；年龄14.9±2.7岁）受伤后约7天和4个月时采集非空腹血浆样本，并与41名匹配的健康对照者（HC：20名女性；年龄14.3±2.8岁）进行比较。结合一系列临床检查对样本中的胶质纤维酸性蛋白（GFAP）、神经丝轻链（NFL）、tau蛋白、磷酸化tau蛋白181（pTau181）和泛素羧基末端水解酶L1（UCH-L1）蛋白浓度进行分析。在受伤后约7天（p<0.001；Cohen's d=0.72）和4个月左右（p=0.015；Cohen's d=0.41），NFL存在诊断差异（pmTBI>HC）。与无精神状态改变（如创伤后遗忘）的患者相比，有精神状态显著改变的pmTBI患者NFL水平也升高（p=0.014；Cohen's d=0.77）。UCH-L1、GFAP和pTau181在两组之间无差异，但与受伤后天数呈负相关（效应量小至中等），提示其释放/清除更快。脑震荡后症状在受伤后约7天诊断分类准确性最高，但在受伤后4个月时NFL的诊断价值更高。初步研究结果突出了pmTBI第一周血液生物标志物的动态波动，以及4个月时持续存在的蛋白释放（NFL）证据。NFL在区分pmTBI范围内的损伤严重程度方面显示出更大的前景。
