Attwood Jonathan E, Lövgren Izabelle, Forsyth Rob, Demarchi Célia, Thayanandan Tony, Prisco Lara, Ganau Mario, Roberts Rebecca, Scarff Kate, Newton Julia L, DeLuca Gabriele C, Lawrence Tim
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
Front Neurol. 2025 Jul 17;16:1620178. doi: 10.3389/fneur.2025.1620178. eCollection 2025.
Outcomes following paediatric mild traumatic brain injury (mTBI) are extremely heterogenous. While emerging biomarkers promise enhanced prognostic accuracy, a critical question remains unanswered-which outcome measures provide the most accurate assessment of injury impact? In this article, we highlight barriers to selecting appropriate outcome measures, including variability in how outcomes are defined and the wide range of assessment tools used. With reference to the most recent literature, we summarise current evidence of adverse outcomes following paediatric mTBI and highlight emerging candidate biomarkers of these outcomes. We emphasise the unique challenges associated with interpreting outcome measures in younger patients, from the impact of developmental stage and assessment timing to the influence of injury-independent factors. We assert the need to consider these obstacles when designing and interpreting mTBI biomarker studies. To realise the potential of prognostic biomarkers, future research should prioritise establishing consensus definitions, compiling a set of accessible and comprehensive outcome measures, and capturing injury-independent factors through longitudinal study designs.
小儿轻度创伤性脑损伤（mTBI）后的结果极其异质。虽然新兴的生物标志物有望提高预后准确性，但一个关键问题仍未得到解答——哪些结果指标能最准确地评估损伤影响？在本文中，我们强调了选择合适结果指标的障碍，包括结果定义方式的变异性以及所使用的广泛评估工具。参考最新文献，我们总结了小儿mTBI后不良结果的当前证据，并强调了这些结果的新兴候选生物标志物。我们强调了在较年轻患者中解释结果指标所面临的独特挑战，从发育阶段和评估时间的影响到与损伤无关因素的影响。我们主张在设计和解释mTBI生物标志物研究时需要考虑这些障碍。为了实现预后生物标志物的潜力，未来研究应优先建立共识定义，编制一套可获取且全面的结果指标，并通过纵向研究设计捕捉与损伤无关的因素。
