Monitoring Biomarkers of Cellular Injury and Death in Acute Brain Injury

Sherry H.Y. Chou*, Claudia S. Robertson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Methods: We performed an electronic literature search and systematic review of English language articles on cellular/molecular biomarkers associated with outcome and with disease-specific secondary complications in adult patients with acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), and post-cardiac arrest hypoxic ischemic encephalopathic injuries (HIE).

Background: Molecular biomarkers have revolutionalized diagnosis and treatment of many diseases, such as troponin use in myocardial infarction. Urgent need for high-fidelity biomarkers in neurocritical care has resulted in numerous studies reporting potential candidate biomarkers.

Results: A total of 135 articles were included. Though a wide variety of potential biomarkers have been identified, only neuron-specific enolase has been validated in large cohorts and shows 100 % specificity for poor outcome prediction in HIE patients not treated with therapeutic hypothermia. There are many promising candidate blood and CSF biomarkers in SAH, AIS, ICH, and TBI, but none yet meets criteria for routine clinical use.

Conclusion: Current studies vary significantly in patient selection, biosample collection/processing, and biomarker measurement protocols, thereby limiting the generalizability of overall results. Future large prospective studies with standardized treatment, biosample collection, and biomarker measurement and validation protocols are necessary to identify high-fidelity biomarkers in neurocritical care.

Original languageEnglish (US)
Pages (from-to)187-214
Number of pages28
JournalNeurocritical Care
Volume21
Issue number2
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Keywords

  • Biomarker
  • Cardiac arrest
  • Intracerebral hemorrhage
  • Outcome
  • Stroke
  • Subarachnoid hemorrhage
  • Traumatic brain injury

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Clinical Neurology

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