title: Acute inflammatory biomarker profiles predict depression risk following moderate to severe traumatic brain injury.
abstract: OBJECTIVE
  To examine whether acute inflammation profiles predict posttraumatic depression (PTD) risk 6 and 12 months after traumatic brain injury.
  
  
  METHODS
  University-affiliated level 1 trauma center and community.
  
  
  METHODS
  Adults with moderate to severe traumatic brain injury (acute serum levels: n = 50; acute cerebrospinal fluid (CSF) levels: n = 41).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Patient Health Questionnaire; inflammatory biomarkers (interleukin [IL]-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, tumor necrosis factor α, soluble vascular adhesion molecule [sVCAM-1], soluble intracellular adhesion molecule [sICAM-1], soluble Fas [sFAS]).
  
  
  RESULTS
  Higher levels of acute CSF cytokine surface markers (sVCAM-1, sICAM-1, and sFAS) in an inflammatory biomarker risk (IBR) score were associated with a 3.920-fold increase in the odds of developing PTD at 6 months (95% confidence interval: 1.163-8.672). Having sICAM-1, sVCAM-1, or sFAS above the 75th percentile had a positive predictive value of 85.7% for PTD risk at 6 months. An IBR score including inflammatory biomarkers IL-7 and IL-8 showed a trending association with 12-month PTD risk (odds ratio = 3.166, 95% confidence interval: 0.936-10.708).
  
  
  CONCLUSIONS
  Acute CSF IBR scores show promise for identifying individuals at risk for PTD. Further research should assess acute CSF inflammatory biomarkers' relationships to chronic inflammation as a mechanism of PTD and should explore anti-inflammatory treatments for PTD, as well as prevention and screening protocols, and link inflammatory biomarkers to symptom tracking.
authors.affiliation: Department of Physical Medicine and Rehabilitation (Drs Juengst and Wagner, Messrs Kumar and Goyal, and Ms Failla), Center for Neuroscience (Ms Failla and Dr Wagner), and Safar Center for Resuscitation Research, (Dr Wagner), University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Shannon B
authors.initials: SB
authors.lastname: Juengst
authors.forename: Raj G
authors.initials: RG
authors.lastname: Kumar
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Failla
authors.forename: Akash
authors.initials: A
authors.lastname: Goyal
authors.forename: Amy Kathleen
authors.initials: AK
authors.lastname: Wagner
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001930:Brain Injuries / Q000378:metabolism* / Q000523:psychology*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000209:etiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D007378:Interleukins / Q000378:metabolism; D008297:Male; D012680:Sensitivity and Specificity; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism; D055815:Young Adult; D019014:fas Receptor / Q000378:metabolism
chemical_list: D015415:Biomarkers; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D019014:fas Receptor; D018799:Intercellular Adhesion Molecule-1