Traumatic brain injury biomarkers in pediatric patients: a systematic review
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Universidade Federal de Minas Gerais
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Resumo
Traumatic brain injury (TBI) is the main cause of pediatric trauma death and disability worldwide. Recent studies have
sought to identify biomarkers of TBI for the purpose of assessing functional outcomes. The aim of this systematic review
was to evaluate the utility of TBI biomarkers in the pediatric population by summarizing recent fndings in the medical
literature. A total of 303 articles were retrieved from our search. An initial screening to remove duplicate studies yielded
162 articles. After excluding all articles that did not meet the inclusion criteria, 56 studies were gathered. Among the 56
studies, 36 analyzed serum biomarkers; 11, neuroimaging biomarkers; and 9, cerebrospinal fuid (CSF) biomarkers. Most
studies assessed biomarkers in the serum, refecting the feasibility of obtaining blood samples compared to obtaining CSF
or performing neuroimaging. S100B was the most studied serum biomarker in TBI, followed by SNE and UCH-L1, whereas
in CSF analysis, there was no unanimity. Among the diferent neuroimaging techniques employed, difusion tensor imag ing (DTI) was the most common, seemingly holding diagnostic power in the pediatric TBI clinical setting. The number of cross-sectional studies was similar to the number of longitudinal studies. Our data suggest that S100B measurement has high sensitivity and great promise in diagnosing pediatric TBI, ideally when associated with head CT examination and clinical decision protocols. Further large-scale longitudinal studies addressing TBI biomarkers in children are required to establish more accurate diagnostic protocols and prognostic tools.
Abstract
Assunto
Lesões Encefálicas Traumáticas, Pediatria, Biomarcadores Farmacológicos, Subunidade beta da Proteína Ligante de Cálcio S100, Neuroimagem
Palavras-chave
Traumatic brain injury, Pediatrics, Biomarkers, S100B, Neuroimaging
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https://link.springer.com/article/10.1007/s10143-021-01588-0