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Fluid Biomarkers of Pediatric Mild Traumatic Brain Injury: A Systematic Review
Rebekah Mannix1, Rachel Levy2, Roger Zemek3
1Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Insights
Diagnosing pediatric mild traumatic brain injury (mTBI) is difficult due to a lack of reliable fluid biomarkers. More research is needed to understand their role in injury and recovery for children.
Area of Science:
- Pediatric Neurology
- Biomarker Research
- Traumatic Brain Injury
Background:
- Growing public concern exists regarding the short- and long-term effects of pediatric mild traumatic brain injury (mTBI).
- Undiagnosed mTBI in acute care settings increases children's risk of reinjury before full recovery.
- Current mTBI management is hindered by the absence of validated biomarkers for objective diagnosis, prognosis, and recovery assessment.
Purpose of the Study:
- To systematically review the existing literature on fluid-based biomarkers for diagnosing and managing pediatric mild traumatic brain injury (mTBI).
- To assess the quality and clinical impact of current studies investigating fluid biomarkers in pediatric mTBI.
- To identify gaps in research and highlight the need for future longitudinal studies.
Main Methods:
- Systematic review of published studies on fluid biomarkers in pediatric mild traumatic brain injury (mTBI).
- Analysis of the quality and scope of existing research, focusing on diagnostic and prognostic utility.
- Evaluation of challenges specific to pediatric populations in biomarker investigation.
Main Results:
- A significant paucity of high-quality, clinically relevant studies on fluid biomarkers for pediatric mTBI was identified.
- Existing studies represent a small fraction of the pediatric mTBI population, limiting generalizability.
- Challenges unique to pediatric research may impede the investigation of promising fluid biomarkers.
Conclusions:
- There is a critical need for well-designed, longitudinal studies to evaluate fluid biomarkers in pediatric mTBI.
- Further research is required across diverse care settings to establish the utility of fluid biomarkers for injury and recovery.
- Objective diagnostic and prognostic tools are essential for improving the management of pediatric mild traumatic brain injury.
Abstract:
Public concern is growing about the short- and long-term effects of pediatric mild traumatic brain injury (mTBI). This concern is amplified because pediatric mTBI has the potential to go undiagnosed in acute care settings, placing children at increased risk for reinjury prior to complete recovery. The management of mTBI can be particularly challenging due to the lack of validated biomarkers that clinicians can use to objectively diagnose pediatric mTBI, predict risk for prolonged recovery, or demonstrate mTBI recovery. Fluid-based biomarkers have drawn increased attention as an objective measure to diagnose and manage pediatric mTBI, but investigations of promising biomarkers may pose unique challenges in pediatric populations. Our systematic review confirms the relative paucity of high-quality, clinically impactful diagnostic or prognostic fluid biomarker studies, on samples representing only a small fraction of pediatric mTBI. Ultimately, well-designed longitudinal studies across diverse points of care are needed to truly characterize the utility of fluid biomarkers of injury and recovery for the pediatric mTBI patient.
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