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Journal of Neuroinflammation
Published in: Journal of Neuroinflammation 1/2016

Open Access 01-12-2016 | Research

Multivariate projection method to investigate inflammation associated with secondary insults and outcome after human traumatic brain injury: a pilot study

Authors: Anna Teresa Mazzeo, Claudia Filippini, Rosalba Rosato, Vito Fanelli, Barbara Assenzio, Ian Piper, Timothy Howells, Ilaria Mastromauro, Maurizio Berardino, Alessandro Ducati, Luciana Mascia

Published in: Journal of Neuroinflammation | Issue 1/2016

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Abstract

Background

Neuroinflammation has been proposed as a possible mechanism of brain damage after traumatic brain injury (TBI), but no consensus has been reached on the most relevant molecules. Furthermore, secondary insults occurring after TBI contribute to worsen neurological outcome in addition to the primary injury. We hypothesized that after TBI, a specific pattern of cytokines is related to secondary insults and outcome.

Methods

A prospective observational clinical study was performed. Secondary insults by computerized multimodality monitoring system and systemic value of different cytokines were collected and analysed in the first week after intensive care unit admission. Neurological outcome was assessed at 6 months (GOSe). Multivariate projection technique was applied to analyse major sources of variation and collinearity within the cytokines dataset without a priori selecting potential relevant molecules.

Results

Twenty-nine severe traumatic brain injury patients undergoing intracranial pressure monitoring were studied. In this pilot study, we demonstrated that after TBI, patients who suffered of prolonged and severe secondary brain damage are characterised by a specific pattern of cytokines. Patients evolving to brain death exhibited higher levels of inflammatory mediators compared to both patients with favorable and unfavorable neurological outcome at 6 months. Raised ICP and low cerebral perfusion pressure occurred in 21 % of good monitoring time. Furthermore, the principal components selected by multivariate projection technique were powerful predictors of neurological outcome.

Conclusions

The multivariate projection method represents a valuable methodology to study neuroinflammation pattern occurring after secondary brain damage in severe TBI patients, overcoming multiple putative interactions between mediators and avoiding any subjective selection of relevant molecules.
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Metadata
Title
Multivariate projection method to investigate inflammation associated with secondary insults and outcome after human traumatic brain injury: a pilot study
Authors
Anna Teresa Mazzeo
Claudia Filippini
Rosalba Rosato
Vito Fanelli
Barbara Assenzio
Ian Piper
Timothy Howells
Ilaria Mastromauro
Maurizio Berardino
Alessandro Ducati
Luciana Mascia
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Neuroinflammation / Issue 1/2016
Electronic ISSN: 1742-2094
DOI
https://doi.org/10.1186/s12974-016-0624-5

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