Release of biochemical markers of damage to neuronal and glial brain tissue is associated with short and long term neuropsychological outcome after traumatic brain injury

被引:143
作者
Herrmann, M
Curio, N
Jost, S
Grubich, C
Ebert, AD
Fork, ML
Synowitz, H
机构
[1] Otto von Guericke Univ, Fac Med, Div Neuropsychol & Behav Neurol, D-39120 Magdeburg, Germany
[2] Hanse Inst Adv Study, Dept Neurol 2, Bremen, Germany
[3] Hanse Inst Adv Study, Dept Neurosurg, Bremen, Germany
关键词
traumatic brain injury; neuron-specific enolase; protein S-100B; neuropsychology; outcome;
D O I
10.1136/jnnp.70.1.95
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives-The present study aimed at the analysis of release patterns of neurobiochemical markers of brain damage (neuron specific enolase (NSE) and protein S-100B) in patients with traumatic brain injury and their predictive value with respect to the short and long term neuropsychological outcome. Methods-Serial NSE and S-100B concentrations were analysed in blood samples taken at the first, second, and third day after traumatic brain injury. In 69 patients who fulfilled the inclusion criteria (no history of neurological or psychiatric disorder or alcohol or drug dependency, blood sampling according to the scheduled time scale, aged between 16 and 65 years) standardised neurological examinations and qualitative and quantitative evaluation of CT were performed. Comprehensive neuropsychological assessment was performed in 39 subjects 2 weeks after admission and in 29 subjects at a 6 month follow up examination. Results-Most patients presented with minor head injuries (GCS greater than or equal to 3) at the time of admission. Six months later most patients were fully independent in activities of daily living. Two thirds of the patients, however, still had neuropsychological dysfunction. Patients with short and long term neuropsychological disorders had significantly higher NSE and S-100B serum concentrations and a significantly longer lasting release of both markers. A comparative analysis of the predictive value of clinical, neuroradiological, and biochemical data showed initial S-100B values above 140 ng/l to have the highest predictive power. Conclusions-The analysis of posttraumatic release patterns of neurobiochemical markers of brain damage might help to identify patients with traumatic brain injury who run a risk of long term neuropsychological dysfunction.
引用
收藏
页码:95 / 100
页数:6
相关论文
共 39 条
[1]  
ETTLIN T, 1999, SCI PRACT NEUROPSYCH, P233
[2]   MINI-MENTAL STATE - PRACTICAL METHOD FOR GRADING COGNITIVE STATE OF PATIENTS FOR CLINICIAN [J].
FOLSTEIN, MF ;
FOLSTEIN, SE ;
MCHUGH, PR .
JOURNAL OF PSYCHIATRIC RESEARCH, 1975, 12 (03) :189-198
[3]  
Gale S D, 1995, J Int Neuropsychol Soc, V1, P17
[4]  
GENTRY LR, 1988, AM J NEURORADIOL, V9, P101, DOI 10.2214/ajr.150.3.663
[5]   S-100 PROTEIN AND NEURON-SPECIFIC ENOLASE IN CSF AFTER EXPERIMENTAL TRAUMATIC OR FOCAL ISCHEMIC BRAIN-DAMAGE [J].
HARDEMARK, HG ;
ERICSSON, N ;
KOTWICA, Z ;
RUNDSTROM, G ;
MENDELHARTVIG, I ;
OLSSON, Y ;
PAHLMAN, S ;
PERSSON, L .
JOURNAL OF NEUROSURGERY, 1989, 71 (05) :727-731
[6]   RELATIONSHIPS BETWEEN IMPAIRMENT AND PHYSICAL-DISABILITY AS MEASURED BY THE FUNCTIONAL INDEPENDENCE MEASURE [J].
HEINEMANN, AW ;
LINACRE, JM ;
WRIGHT, BD ;
HAMILTON, BB ;
GRANGER, C .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 1993, 74 (06) :566-573
[7]   Temporal profile of release of neurobiochemical markers of brain damage after traumatic brain injury is associated with intracranial pathology as demonstrated in cranial computerized tomography [J].
Herrmann, M ;
Jost, S ;
Kutz, S ;
Ebert, AD ;
Kratz, T ;
Wunderlich, MT ;
Synowitz, H .
JOURNAL OF NEUROTRAUMA, 2000, 17 (02) :113-122
[8]  
Herrmann M, 1999, RESTOR NEUROL NEUROS, V14, P109
[9]   S100 beta induces apoptotic cell death in cultured astrocytes via a nitric oxide-dependent pathway [J].
Hu, JR ;
VanEldik, LJ .
BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH, 1996, 1313 (03) :239-245
[10]  
Hu JR, 1997, J NEUROCHEM, V69, P2294