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Published in: Journal of Neurology 4/2024

29-12-2023 | Biomarkers | Original Communication

An exploratory study on the association between blood-based biomarkers and subacute neurometabolic changes following mild traumatic brain injury

Authors: Koen Visser, Myrthe E. de Koning, Diana Ciubotariu, Marius G. J. Kok, Anita J. Sibeijn-Kuiper, Arno R. Bourgonje, Harry van Goor, Joukje van der Naalt, Harm Jan van der Horn

Published in: Journal of Neurology | Issue 4/2024

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Abstract

Background and objectives

Blood-based biomarkers and advanced neuroimaging modalities such as magnetic resonance spectroscopy (MRS) or diffusion tensor imaging (DTI) have enhanced our understanding of the pathophysiology of mild traumatic brain injury (mTBI). However, there is limited published data on how blood biomarkers relate to neuroimaging biomarkers post-mTBI.

Methods

To investigate this, 30 patients with mTBI and 21 healthy controls were enrolled. Data was collected at two timepoints postinjury: acute, < 24 h, (blood) and subacute, four-to-six weeks, (blood and imaging). Interleukin (IL) 6 and 10 (inflammation), free thiols (systemic oxidative stress) and neurofilament light (NF-L) (axonal injury) were quantified in plasma. The neurometabolites total N-acetyl aspartate (tNAA) (neuronal energetics), Myo-Inositol (Ins) and total Choline (tCh) (inflammation) and, Glutathione (GSH, oxidative stress) were quantified using MRS.

Results

Concentrations of IL-6 and IL-10 were significantly elevated in the acute phase post-mTBI, while NF-L was elevated only in the subacute phase. Total NAA was lowered in patients with mTBI, although this difference was only nominally significant (uncorrected P < 0.05). Within the patient group, acute IL-6 and subacute tNAA levels were negatively associated (r =  − 0.46, uncorrected-P = 0.01), albeit not at a threshold corrected for multiple testing (corrected-P = 0.17). When age was added as a covariate a significant increase in correlation magnitude was observed (ρ =  − 0.54, corrected-P = 0.03).

Conclusion

This study demonstrates potential associations between the intensity of the inflammatory response in the acute phase post-mTBI and neurometabolic perturbations in the subacute phase. Future studies should assess the longitudinal dynamics of blood-based and imaging biomarkers after injury.
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Metadata
Title
An exploratory study on the association between blood-based biomarkers and subacute neurometabolic changes following mild traumatic brain injury
Authors
Koen Visser
Myrthe E. de Koning
Diana Ciubotariu
Marius G. J. Kok
Anita J. Sibeijn-Kuiper
Arno R. Bourgonje
Harry van Goor
Joukje van der Naalt
Harm Jan van der Horn
Publication date
29-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 4/2024
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-023-12146-7

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