Multiplex Assessment of Serum Biomarker Concentrations in Well-Appearing Children With Inflicted Traumatic Brain Injury

Proper diagnosis of mild inflicted traumatic brain injury (ITBI) is difficult; children often present without a history of trauma and with nonspecific symptoms, such as vomiting. Previous Studies suggest that biomarkers may be able to screen for brain injury in this population, but these studies focused on only a few biomarkers. We hypothesized that using multiplex bead technology we would be able to identify multiple differences in the serum biomarker profile between in children with ITBI and those without brain injury. We compared the concentrations of 44 serum biomarkers in 16 infants with mild ITBI and 20 infants without brain injury. There were significant group differences in the concentrations of nine of the 44 markers. Vascular cellular adhesion molecule (VCAM) (p < 0.00) and IL-6 (IL-6) (p < 0.00) had the most significant group differences; IL-6 was higher after ITBI, whereas VCAM was lower. Using VCAM and IL-6 in classification algorithms, we could discriminate the groups with a sensitivity and specificity of 87% and 90%, respectively. The results suggest significant changes in the serum biomarker profile after mild ITBI. Future research is needed to determine whether these biomarkers can screen for brain injury in infants with nonspecific symptoms. (Pediatr Res 65: 97-102, 2009)