Hyperphosphorylated neurofilament NF-H, S100β and NSE as indicators of severity of brain injury in children

Introduction

The aim of the study was to determine whether serum levels of biomarkers - hyperphosphorylated neurofilament NF-H, S100β protein and NSE - correlate with severity of brain injury and outcome in children with traumatic brain injury (TBI).

Methods

Thirty-eight patients with TBI were enrolled in the prospective study. TBI was verified by computerized tomography according to the Marshall classification. Venous blood samples were taken after admission and every 24 hours for a maximum of 6 consecutive days. Serum NF-H concentrations were quantified by ELISA, S100β and NSE by electrogenerated chemiluminescence. The outcome was evaluated 6 months after TBI using the Glasgow Outcome Scale (GOS) in all patients.

Results

Serum concentrations of NF-H (median 86 vs 12; P = 0.01), S100β (median 3.47 vs 0.54; P = 0.001), and NSE (median 193.2 vs 37.03; P = 0.001) were higher in nonsurvivors than survivors. Serum NF-H (median 86 vs 12; P = 0.004), S100β (median 3.47 vs 0.54; P = 0.001) and NSE (median 193.2 vs 37.03; P = 0.001) was significantly higher in patients with unfavourable outcome (GOS ≤3 vs GOS >3). Spearman's ank correlation coefficient on first day of hospitalization S100B × NSE = 0.58 (P < 0.05), GCS × GOS = 0.50 (P < 0.05), GOS × Marshall classification = 0.46 (P < 0.05).

Conclusions

Plasma levels of hyperphosphorylated neurofilament, S100β and NSE correlate with severity of TBI and may be useful as predictors of outcome in children with TBI.