Advances in TBI: Emerging Role of Imaging and Blood Biomarkers

apa-logo_white_screenThe International Neuropsychological Society is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Neuropsychological Society maintains responsibility for this program and its content.
Educational Objectives
  1. Describe the emergence of blood and imaging biomarkers of TBI and concussion
  2. Discuss data from large scale TBI biomarkers studies in civilians, athletes and military
  3. Explain the pathway for translation of biomarkers to clinical practice
  4. Name the relevant blood biomarkers studied within pediatric TBI and discuss what they measure​​
  5. Identify the strengths of current biomarkers and how they could be used within clinical practice
  6. Discuss what Osteopontin is and how it is related to outcomes in pediatric TBI

 

Course Information
Target Audience:Intermediate
Availability:Date Available: 2021-09-10
  You may obtain CE for this webinar at any time.
Offered for CE Yes
Cost Members $20
  Non-Members $30
Refund Policy This webinar is not eligible for refunds
CE Credits 1.5
Abstract
Across all areas of medicine and research, biomarkers are proving to provide great value in diagnosis, prognosis, and treatment of injury or disease. Major progress has been achieved toward advancing blood and imaging biomarkers for TBI and concussion. This session will review emerging evidence from large-scale studies of TBI biomarkers in civilians, athletes and military service members. Pathways for clinical translation and implementation will be discussed. Traumatic Brain Injury (TBI) continues to be one of the leading causes of death and disability in the pediatric population. Current prediction models explain only about 35% of variance in outcomes. At the individual patient level, this unexplained heterogeneity in outcomes prevents accurate prognostication and precision medicine approaches. A simple blood-based biomarker that correlates with the severity and progression of brain injury, similar to troponin in myocardial infarction, would enable appropriate triage in acute treatment, rehabilitation planning, and clinical trial stratification. Yet, few studies have specifically examined blood biomarkers in pediatric TBI. This session will review the current state of biomarker research within pediatric TBI as well as discuss several novel blood biomarkers that have shown promise in the recent years.
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References
  1. Gao N, Zhang-Brotzge X, Wali B, Sayeed I, Chern JJ, Blackwell LS, et al. Plasma osteopontin may predict neuroinflammation and the severity of pediatric traumatic brain injury. J Cereb Blood Flow Metab 2020;40: 35-43.
  2. Blackwell, L.S., Martinez, M., Fournier-Goodnight, A., Figueroa, J., Appert, A., Vats, A., Wali, B., Sayeed, I., & Reisner, A. Patterns of Osteopontin Expression in Abusive Head Trauma Compared to Other Causes of Pediatric Traumatic Brain Injury. J Pediatri. 2020 Dec;227:170-175. doi: 10.1016/j.jpeds.2020.06.080. Epub 2020 Jul 2.
  3. Mondello, S.; Kobeissy, F.; Vestri, A.; Hayes, R.L.; Kochanek, P.M.; Berger, R.P. Serum concentrations of ubiquitin c-terminal hydrolase-l1 and glial fibrillary acidic protein after pediatric traumatic brain injury. Sci. Rep. 2016, 6, 28203.
  4. Fraser DD, Close TE, Rose KL, Ward R, Mehl M, Farrell C, et al. Severe traumatic brain injury in children elevates glial fibrillary acidic protein in cerebrospinal fluid and serum. Pediatr Crit Care Med. 2011;12:319–324.
  5. Wang KK, Yang Z, Zhu T, Shi Y, Rubenstein R, Tyndall JA, et al. (2018). An update on diagnostic and prognostic biomarkers for traumatic brain injury. Expert Rev Mol Diagn, 18:165-80.
  6. ​​​​​​​Centers for Disease Control and Prevention. (2018). Report to Congress: The Management of Traumatic Brain Injury in Children, National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention. Atlanta, GA.

Disclosures
None

Author(s)
  • Michael McCrea is Tenured Professor of Neurosurgery and Co-Director of the Center for Neurotrauma Research at the Medical College of Wisconsin. He has been an active researcher in the neurosciences, with numerous scientific publications, book chapters, and national and international lectures on the acute and chronic effects of traumatic brain injury. Dr. McCrea has led several large, multi-center studies on traumatic brain injury (TBI) and concussion. He is currently co-PI of the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium and co-I on the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study and TBI Endpoints Development (TED) study. He serves on the National Academies of Sciences, Engineering, and Medicine (NASEM) Committee on Accelerating Progress in TBI Research and Care and has served on several other expert panels related to TBI over the past 25 years.

  • Laura Blackwell is a board certified pediatric neuropsychologist at the Children’s Healthcare of Atlanta. She is currently the director of the Pediatric Neurotrauma Lab, a translational research lab investigating outcomes in pediatric brain injury, as well as the co-director of the CHOA Fellowship in Pediatric Neuropsychology. Dr. Blackwell’s research focuses on examining early predictors of recovery and outcome in pediatric brain injury with an emphasis on examining biological markers of injury and exploring their potential role in both treatment and recovery.
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