TY - JOUR
T1 - The Levels of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 During the First Week After a Traumatic Brain Injury
T2 - Correlations With Clinical and Imaging Findings
AU - Posti, Jussi
AU - Takala, Riikka S.K.
AU - Runtti, Hilkka
AU - Newcombe, Virginia F.
AU - Outtrim, Joanne
AU - Katila, Ari J.
AU - Frantzén, Janek
AU - Ala-Seppälä, Henna
AU - Coles, Jonathan P.
AU - Hossain, Md. Iftakher
AU - Kyllönen, Anna
AU - Maanpää, Henna-Riikka
AU - Tallus, Jussi
AU - Hutchinson, Peter J.
AU - van Gils, Mark
AU - Menon, David K.
AU - Tenovuo, Olli
N1 - SDA: MIP: Personalized H&WB
PY - 2016
Y1 - 2016
N2 - BACKGROUND: Glial fibrillary acidic protein (GFAP) and
ubiquitin C-terminal hydrolase-
L1 (UCH-L1) are promising biomarkers of traumatic brain
injury (TBI).
OBJECTIVE: We investigated the relation of the GFAP and
UCH-L1 levels to the severity
of TBI during the first week after injury.
METHODS: Plasma UCH-L1 and GFAP were measured from 324
consecutive patients
with acute TBI and 81 control subject enrolled in a
2-center prospective study. The
baseline measures included initial Glasgow Coma Scale
(GCS), head computed tomographic
(CT) scan at admission, and blood samples for protein
biomarkers that were
collected at admission and on days 1, 2, 3, and 7 after
injury.
RESULTS: Plasma levels of GFAP and UCH-L1 during the
first 2 days after the injury strongly
correlated with the initial severity of TBI as assessed
with GCS. Additionally, levels of UCH-L1
on the seventh day after the injury were significantly
related to the admission GCS scores. At
admission, both biomarkers were capable of distinguishing
mass lesions from diffuse injuries
in CT, and the area under the curve of the
receiver-operating characteristic curve for prediction
of any pathological finding in CT was 0.739 (95%
confidence interval, 0.636-0.815)
and 0.621 (95% confidence interval, 0.517-0.713) for GFAP
and UCH-L1, respectively.
CONCLUSION: These results support the prior findings of
the potential role of GFAP
and UCH-L1 in acute-phase diagnostics of TBI. The novel
finding is that levels of GFAP
and UCH-L1 correlated with the initial severity of TBI
during the first 2 days after the
injury, thus enabling a window for TBI diagnostics with
latency.
AB - BACKGROUND: Glial fibrillary acidic protein (GFAP) and
ubiquitin C-terminal hydrolase-
L1 (UCH-L1) are promising biomarkers of traumatic brain
injury (TBI).
OBJECTIVE: We investigated the relation of the GFAP and
UCH-L1 levels to the severity
of TBI during the first week after injury.
METHODS: Plasma UCH-L1 and GFAP were measured from 324
consecutive patients
with acute TBI and 81 control subject enrolled in a
2-center prospective study. The
baseline measures included initial Glasgow Coma Scale
(GCS), head computed tomographic
(CT) scan at admission, and blood samples for protein
biomarkers that were
collected at admission and on days 1, 2, 3, and 7 after
injury.
RESULTS: Plasma levels of GFAP and UCH-L1 during the
first 2 days after the injury strongly
correlated with the initial severity of TBI as assessed
with GCS. Additionally, levels of UCH-L1
on the seventh day after the injury were significantly
related to the admission GCS scores. At
admission, both biomarkers were capable of distinguishing
mass lesions from diffuse injuries
in CT, and the area under the curve of the
receiver-operating characteristic curve for prediction
of any pathological finding in CT was 0.739 (95%
confidence interval, 0.636-0.815)
and 0.621 (95% confidence interval, 0.517-0.713) for GFAP
and UCH-L1, respectively.
CONCLUSION: These results support the prior findings of
the potential role of GFAP
and UCH-L1 in acute-phase diagnostics of TBI. The novel
finding is that levels of GFAP
and UCH-L1 correlated with the initial severity of TBI
during the first 2 days after the
injury, thus enabling a window for TBI diagnostics with
latency.
KW - biomarker
KW - GFAP
KW - Severity
KW - traumatic brain injury
KW - UCH-L1
U2 - 10.1227/NEU.0000000000001226
DO - 10.1227/NEU.0000000000001226
M3 - Article
SN - 0148-396X
VL - 79
SP - 456
EP - 464
JO - Neurosurgery
JF - Neurosurgery
IS - 3
ER -