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BMC Pediatr. 2017 Jul 24;17(1):173. doi: 10.1186/s12887-017-0925-6.

Brain biomarkers and pre-injury cognition are associated with long-term cognitive outcome in children with traumatic brain injury.

Author information

1
Department of Psychology, University of Toronto, Toronto, Canada. amy.wilkinson@sickkids.ca.
2
Program in Neuroscience & Mental Health, The Hospital for Sick Children, Toronto, Canada. amy.wilkinson@sickkids.ca.
3
Department of Psychology, University of Toronto, Toronto, Canada.
4
Program in Neuroscience & Mental Health, The Hospital for Sick Children, Toronto, Canada.
5
Department of Surgery, University of Toronto, Toronto, Canada.
6
Comprehensive Pediatric Epilepsy Program, Hamilton Health Sciences Corporation, Hamilton, Canada.
7
Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.
8
Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Canada.
9
Division of Pediatric Intensive Care, Department of Pediatrics, Children's Hospital of Hamilton, Hamilton, Canada.
10
Pediatrics, Clinical Neurological Sciences and Epidemiology, Schulich School of Medicine, Western University, London, Canada.
11
Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
12
Psychological Sciences and Pediatrics, University of Melbourne, Melbourne, Australia.
13
Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.
14
Program in Neuroscience & Mental Health, The Hospital for Sick Children, Toronto, Canada. jamie.hutchison@sickkids.ca.
15
Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Canada. jamie.hutchison@sickkids.ca.

Abstract

BACKGROUND:

Children with traumatic brain injury (TBI) are frequently at risk of long-term impairments of attention and executive functioning but these problems are difficult to predict. Although deficits have been reported to vary with injury severity, age at injury and sex, prognostication of outcome remains imperfect at a patient-specific level. The objective of this proof of principle study was to evaluate a variety of patient variables, along with six brain-specific and inflammatory serum protein biomarkers, as predictors of long-term cognitive outcome following paediatric TBI.

METHOD:

Outcome was assessed in 23 patients via parent-rated questionnaires related to attention deficit hyperactivity disorder (ADHD) and executive functioning, using the Conners 3rd Edition Rating Scales (Conners-3) and Behaviour Rating Inventory of Executive Function (BRIEF) at a mean time since injury of 3.1 years. Partial least squares (PLS) analyses were performed to identify factors measured at the time of injury that were most closely associated with outcome on (1) the Conners-3 and (2) the Behavioural Regulation Index (BRI) and (3) Metacognition Index (MI) of the BRIEF.

RESULTS:

Higher levels of neuron specific enolase (NSE) and lower levels of soluble neuron cell adhesion molecule (sNCAM) were associated with higher scores on the inattention, hyperactivity/impulsivity and executive functioning scales of the Conners-3, as well as working memory and initiate scales of the MI from the BRIEF. Higher levels of NSE only were associated with higher scores on the inhibit scale of the BRI.

CONCLUSIONS:

NSE and sNCAM show promise as reliable, early predictors of long-term attention-related and executive functioning problems following paediatric TBI.

KEYWORDS:

Attention; Executive functions; Serum biomarkers; Traumatic brain injury

PMID:
28738850
PMCID:
PMC5525296
DOI:
10.1186/s12887-017-0925-6
[Indexed for MEDLINE]
Free PMC Article

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