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Traumatic brain injury biomarkers in pediatric patients: a systematic review

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Abstract

Traumatic brain injury (TBI) is the main cause of pediatric trauma death and disability worldwide. Recent studies have sought to identify biomarkers of TBI for the purpose of assessing functional outcomes. The aim of this systematic review was to evaluate the utility of TBI biomarkers in the pediatric population by summarizing recent findings in the medical literature. A total of 303 articles were retrieved from our search. An initial screening to remove duplicate studies yielded 162 articles. After excluding all articles that did not meet the inclusion criteria, 56 studies were gathered. Among the 56 studies, 36 analyzed serum biomarkers; 11, neuroimaging biomarkers; and 9, cerebrospinal fluid (CSF) biomarkers. Most studies assessed biomarkers in the serum, reflecting the feasibility of obtaining blood samples compared to obtaining CSF or performing neuroimaging. S100B was the most studied serum biomarker in TBI, followed by SNE and UCH-L1, whereas in CSF analysis, there was no unanimity. Among the different neuroimaging techniques employed, diffusion tensor imaging (DTI) was the most common, seemingly holding diagnostic power in the pediatric TBI clinical setting. The number of cross-sectional studies was similar to the number of longitudinal studies. Our data suggest that S100B measurement has high sensitivity and great promise in diagnosing pediatric TBI, ideally when associated with head CT examination and clinical decision protocols. Further large-scale longitudinal studies addressing TBI biomarkers in children are required to establish more accurate diagnostic protocols and prognostic tools.

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Acknowledgements

This article received financial support from 2016 NARSAD Young Investigator Grant from Brain & Behavior Research Foundation (grant #25414), 2019 “For Women in Science”—L’Oreal Brazil-UNESCO—Brazilian Academy of Science (ABC), FAPEMIG (Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Brazil), CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil), and CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior).

Funding

This article received financial support from 2016 NARSAD Young Investigator Grant from Brain & Behavior Research Foundation (grant #25414), 2019 “For Women in Science”—L’Oreal Brazil-UNESCO—Brazilian Academy of Science (ABC), FAPEMIG (Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Brazil), CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil), and CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior).

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Authors and Affiliations

  1. Laboratório Interdisciplinar de Investigação Médica (LIIM), Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), CEP 30.130-100, Avenida Professor Alfredo Balena, nº190/sl 281, Santa Efigênia, Belo Horizonte, MG, Brazil

    Lucas Alexandre Santos Marzano, Joao Pedro Thimotheo Batista, Marina de Abreu Arruda, Maíra Glória de Freitas Cardoso, João Luís Vieira Monteiro de Barros, Janaína Matos Moreira, Priscila Menezes Ferri Liu, Ana Cristina Simões e Silva & Aline Silva de Miranda

  2. Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil

    Janaína Matos Moreira, Priscila Menezes Ferri Liu & Ana Cristina Simões e Silva

  3. Santa Casa BH Ensino E Pesquisa, Belo Horizonte, MG, Brazil

    Antônio Lúcio Teixeira

  4. Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center At Houston, Houston, TX, USA

    Antônio Lúcio Teixeira

  5. Laboratório de Neurobiologia, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil

    Aline Silva de Miranda

  6. Programa de Pós-Graduação Em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil

    Aline Silva de Miranda

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  1. Lucas Alexandre Santos Marzano
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  2. Joao Pedro Thimotheo Batista
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  3. Marina de Abreu Arruda
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  10. Aline Silva de Miranda
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Contributions

L.A.S.M., J.P.T.B., and M.A.A. drafted the review; M.G.F.C., J.L.V.M.B., J.M.M., and P.M.F.L. revised and edited the manuscript; A.L.T., A.C.S.S., and A.S.M. elaborated, revised, and edited the manuscript.

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Correspondence to Aline Silva de Miranda.

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Marzano, L.A.S., Batista, J.P.T., de Abreu Arruda, M. et al. Traumatic brain injury biomarkers in pediatric patients: a systematic review. Neurosurg Rev 45, 167–197 (2022). https://doi.org/10.1007/s10143-021-01588-0

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