The Levels of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 During the First Week After a Traumatic Brain Injury: Correlations With Clinical and Imaging Findings

Jussi Posti (Corresponding Author), Riikka S.K. Takala, Hilkka Runtti, Virginia F. Newcombe, Joanne Outtrim, Ari J. Katila, Janek Frantzén, Henna Ala-Seppälä, Jonathan P. Coles, Md. Iftakher Hossain, Anna Kyllönen, Henna-Riikka Maanpää, Jussi Tallus, Peter J. Hutchinson, Mark van Gils, David K. Menon, Olli Tenovuo

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

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.
Original languageEnglish
Pages (from-to)456-464
JournalNeurosurgery
Volume79
Issue number3
DOIs
Publication statusPublished - 2016
MoE publication typeA1 Journal article-refereed

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Ubiquitin Thiolesterase
Glial Fibrillary Acidic Protein
Protein C
Glasgow Coma Scale
Wounds and Injuries
Biomarkers
Confidence Intervals
Traumatic Brain Injury
ROC Curve
Brain Injuries
Area Under Curve
Blood Proteins
Head
Prospective Studies

Keywords

  • biomarker
  • GFAP
  • Severity
  • traumatic brain injury
  • UCH-L1

Cite this

Posti, Jussi ; Takala, Riikka S.K. ; Runtti, Hilkka ; Newcombe, Virginia F. ; Outtrim, Joanne ; Katila, Ari J. ; Frantzén, Janek ; Ala-Seppälä, Henna ; Coles, Jonathan P. ; Hossain, Md. Iftakher ; Kyllönen, Anna ; Maanpää, Henna-Riikka ; Tallus, Jussi ; Hutchinson, Peter J. ; van Gils, Mark ; Menon, David K. ; Tenovuo, Olli. / The Levels of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 During the First Week After a Traumatic Brain Injury: Correlations With Clinical and Imaging Findings. In: Neurosurgery. 2016 ; Vol. 79, No. 3. pp. 456-464.
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title = "The Levels of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 During the First Week After a Traumatic Brain Injury: Correlations With Clinical and Imaging Findings",
abstract = "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.",
keywords = "biomarker, GFAP, Severity, traumatic brain injury, UCH-L1",
author = "Jussi Posti and Takala, {Riikka S.K.} and Hilkka Runtti and Newcombe, {Virginia F.} and Joanne Outtrim and Katila, {Ari J.} and Janek Frantz{\'e}n and Henna Ala-Sepp{\"a}l{\"a} and Coles, {Jonathan P.} and Hossain, {Md. Iftakher} and Anna Kyll{\"o}nen and Henna-Riikka Maanp{\"a}{\"a} and Jussi Tallus and Hutchinson, {Peter J.} and {van Gils}, Mark and Menon, {David K.} and Olli Tenovuo",
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Posti, J, Takala, RSK, Runtti, H, Newcombe, VF, Outtrim, J, Katila, AJ, Frantzén, J, Ala-Seppälä, H, Coles, JP, Hossain, MI, Kyllönen, A, Maanpää, H-R, Tallus, J, Hutchinson, PJ, van Gils, M, Menon, DK & Tenovuo, O 2016, 'The Levels of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 During the First Week After a Traumatic Brain Injury: Correlations With Clinical and Imaging Findings', Neurosurgery, vol. 79, no. 3, pp. 456-464. https://doi.org/10.1227/NEU.0000000000001226

The Levels of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 During the First Week After a Traumatic Brain Injury: Correlations With Clinical and Imaging Findings. / Posti, Jussi (Corresponding Author); Takala, Riikka S.K.; Runtti, Hilkka; Newcombe, Virginia F.; Outtrim, Joanne; Katila, Ari J.; Frantzén, Janek; Ala-Seppälä, Henna; Coles, Jonathan P.; Hossain, Md. Iftakher; Kyllönen, Anna; Maanpää, Henna-Riikka; Tallus, Jussi; Hutchinson, Peter J.; van Gils, Mark; Menon, David K.; Tenovuo, Olli.

In: Neurosurgery, Vol. 79, No. 3, 2016, p. 456-464.

Research output: Contribution to journalArticleScientificpeer-review

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: 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

VL - 79

SP - 456

EP - 464

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 3

ER -