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Serum Metabolites Associated with Computed TomographyFindings after Traumatic Brain Injury
Turku Centre for Biotechnology, University of Turku, Turku, Finland .
Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma, Turku University Hospital, Turku, Finland; Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland .
Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, Turku, Finland .
Department of Neurology,University of Turku, Turku, Finland .
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2018 (English)In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 35, no 22, p. 2673-2683Article in journal (Refereed) Published
Abstract [en]

There is a need to rapidly detect patients with traumatic brain injury (TBI) who require head computed tomography (CT). Given the energy crisis in the brain following TBI, we hypothesized that serum metabolomics would be a useful tool for developing a set of biomarkers to determine the need for CT and to distinguish between different types of injuries observed. Logistic regression models using metabolite data from the discovery cohort (n=144, Turku, Finland) were used to distinguish between patients with traumatic intracranial findings and negative findings on head CT. The resultant models were then tested in the validation cohort (n=66, Cambridge, UK). The levels of glial fibrillary acidic protein and ubiquitin C-terminal hydrolase-L1 were also quantified in the serum from the same patients. Despite there being significant differences in the protein biomarkers in patients with TBI, the model that determined the need for a CT scan validated poorly (AUC=0.64: Cambridge patients). However, using a combination of six metabolites (two amino acids, three sugar derivatives and one ketoacid) it was possible to discriminate patients with intracranial abnormalities on CT and patients with a normal CT (AUC=0.77 in Turku patients and AUC=0.73 in Cambridge patients). Furthermore, a combination of three metabolites could distinguish between diffuse brain injuries and mass lesions (AUC=0.87 in Turku patients and AUC=0.68 in Cambridge patients). This study identifies a set of validated serum polar metabolites, which associate with the need for a CT scan. Additionally, serum metabolites can also predict the nature of the brain injury. These metabolite markers may prevent unnecessary CT scans, thus reducing the cost of diagnostics and radiation load.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2018. Vol. 35, no 22, p. 2673-2683
Keywords [en]
Biomarkers, CT Scanning, Human Sstudies, Metabolism, Traumatic Brain Injury
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-67622DOI: 10.1089/neu.2017.5272ISI: 000449057900007PubMedID: 29947291Scopus ID: 2-s2.0-85056057311OAI: oai:DiVA.org:oru-67622DiVA, id: diva2:1229113
Note

Funding Agencies:

EU FP7 project TBIcare  270259 

GE-NFL Head Health Challenge I Award  7620 

Goverment's Special Financial Transfer tied to academic research in Health Sciences (Finland)  

Emil Aaltonen Foundation  

Finnish Brain Foundation  

National Institute for Health Research  

National Institute for Health Research and Biomedical Research Centre, Cambridge  

National Institute for Health Research Biomedical Research Center, Cambridge (Neuroscience Theme)  

National Institute for Health Research Biomedical Research Center, Cambridge (Brain Injury and Repair Theme)  

NIHR Biomedical Research Centre in Cambridge  

Academy of Medical Sciences/The Health Foundation Fellowship  

Academy of Medical Sciences/Health Foundation Senior Surgical Scientist Fellowship 

Available from: 2018-06-29 Created: 2018-06-29 Last updated: 2019-03-04Bibliographically approved

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Hyötyläinen, TuuliaOresic, Matej

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