Neuron-specific enolase and S100BB as outcome predictors in severe diffuse axonal injury.
BACKGROUND
Diffuse axonal injury (DAI) is a common type of traumatic brain injury, mostly associated with mild changes on computed tomography (CT) scan. Serum biomarkers might be used in the diagnosis and prognosis of this injury type. Our purpose was to determine temporal profile and predictive values of serum concentrations of protein S100BB and neuron-specific enolase (NSE) after DAI.


METHODS
Twenty-eight isolated severe DAI patients (Glasgow Coma Scale score ≤ 8) with normal CT were enrolled in the study. Serum levels of S100BB and NSE were determined at 6 hours, 24 hours, 48 hours, and 72 hours after injury, using enzyme-linked immunosorbent assay. Clinical outcome variables of DAI comprised survival at discharge and Glasgow Outcome scale (GOS) after 3 months and also 2 years.


RESULTS
S100BB concentration was maximum in 6 hours after injury (median = 280.75 ng/L) followed by a quick drop. Its value was significantly higher on third day in patients with unfavorable outcome (GOS score = 1-3) versus favorable outcome (GOS score = 4, 5) (p < 0.0001). The values of NSE had mild changes during 3 days; however, these measured values at 72 hours after trauma manifested higher in unfavorable outcome (p < 0.05).


CONCLUSIONS
Increased serum concentrations of NSE and S100BB within first 3 days after DAI are associated with poor outcome despite mild CT findings. S100BB level at 72 hours after injury can predict late outcome in DAI patients.


METHODS
Prognostic study, level III.
Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Guilan, Iran.
Shahrokh Yousefzadeh
SY
Chabok
Anoush Dehnadi
AD
Moghadam
Zahra
Z
Saneei
Fatemeh Ghazanfari
FG
Amlashi
Ehsan Kazemnezhad
EK
Leili
Zahra Mohtasham
ZM
Amiri
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000201:enzymology; D015331:Cohort Studies; D020833:Diffuse Axonal Injury / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000209:etiology / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000032:analysis / Q000378:metabolism*; D010751:Phosphopyruvate Hydratase / Q000032:analysis / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000032:analysis / Q000378:metabolism*; D012680:Sensitivity and Specificity; D012737:Sex Factors; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase