The Prognostic Role of Candidate Serum Biomarkers in the Post-Acute and Chronic Phases of Disorder of Consciousness: A Preliminary Study

• Published in: Brain sciences 2024-03, Vol.14 (3), p.239
• Main Authors: Formisano, Rita, D'Ippolito, Mariagrazia, Giustini, Marco, Catani, Sheila, Mondello, Stefania, Piccolino, Iliana, Iannuzzi, Filomena, Wang, Kevin K, Hayes, Ronald L
• Format: Article
• Language: English
• Subjects: acquired brain injury; Biological markers; Biomarkers; Blood tests; Brain; Brain damage; Brain-derived neurotrophic factor; Coma; Consciousness; Cytokines; Glial fibrillary acidic protein; Injuries; Medical imaging; Medical research; Medicine, Experimental; MicroRNAs; Neurodegeneration; Neuroimaging; Neurology; Neuronal-glial interactions; Neurophysiology; Persistent vegetative state; prolonged disorders of consciousness; Protein gene product 9.5; Proteins; Recovery (Medical); Rehabilitation; Sampling; serum biomarkers; Statistical analysis; Tau protein; Traumatic brain injury; Tumor necrosis factor-TNF; Ubiquitin carboxy-terminal hydrolase
• ISSN: 2076-3425; 2076-3425
• DOI: 10.3390/brainsci14030239

Serum biomarkers, such as Neurofilament Light (NF-L), Glial Fibrillary Acidic Protein (GFAP), Ubiquitin C-terminal Hydrolase (UCH-L1), and Total-tau (T-Tau) have been proposed for outcome prediction in the acute phase of severe traumatic brain injury, but they have been less investigated in patients with prolonged DoC (p-DoC). We enrolled 25 p-DoC patients according to the Coma Recovery Scale-Revised (CRS-R). We identified different time points: injury onset (t ), first blood sampling at admission in Neurorehabilitation (t ), and second blood sampling at discharge (t ). Patients were split into improved (improved level of consciousness from t to t ) and not-improved (unchanged or worsened level of consciousness from t to t ). All biomarker levels decreased over time, even though each biomarker reveals typical features. Serum GFAP showed a weak correlation between t and t ( = 0.001), while no correlation was observed for serum NF-L ( = 0.955), UCH-L1 ( = 0.693), and T-Tau ( = 0.535) between t and t . Improved patients showed a significant decrease in the level of NF-L ( = 0.0001), UCH-L1 ( = 0.001), and T-Tau ( = 0.002), but not for serum GFAP ( = 0.283). No significant statistical differences were observed in the not-improved group. A significant correlation was found between the level of consciousness improvement and decreased NF-L, UCH-L1, and T-Tau levels. Future studies on the association of serum biomarkers with neurophysiological and neuroimaging prognostic indicators are recommended.