Related Experiment Video
Updated: Dec 16, 2025
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Patterns of Osteopontin Expression in Abusive Head Trauma Compared with Other Causes of Pediatric Traumatic Brain
Laura S Blackwell1, Margaret Martinez2, Ashley Fournier-Goodnight1
1Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA.
Insights
Plasma osteopontin (OPN) levels were significantly higher in children with confirmed abusive head trauma (AHT) compared to other traumatic brain injuries. This neuroinflammatory biomarker may aid in identifying AHT in pediatric patients.
Area of Science:
- Neuroscience
- Pediatrics
- Biomarkers
Background:
- Abusive head trauma (AHT) is a severe form of child abuse with significant morbidity and mortality.
- Early identification of AHT is crucial for timely intervention and improved outcomes.
- Osteopontin (OPN) is a novel neuroinflammatory biomarker with potential diagnostic value.
Purpose of the Study:
- To investigate plasma osteopontin (OPN) levels in pediatric patients diagnosed with abusive head trauma (AHT).
- To compare OPN levels in children with confirmed AHT, suspected AHT, and other forms of traumatic brain injury (TBI).
Main Methods:
- A cohort of children under 4 years old with TBI was studied in a tertiary children's hospital intensive care unit.
- Patients were classified into confirmed AHT, suspected AHT, or other TBI mechanisms by a Child Protection Team.
- Serial plasma samples were collected at admission and at 24, 48, and 72 hours post-admission for OPN level analysis.
Main Results:
- No significant differences in Glasgow Coma Scale scores were observed across the AHT and TBI groups.
- Plasma OPN levels were significantly higher at admission in children with confirmed AHT compared to suspected AHT and other TBI groups.
- Adjusted mean OPN levels remained significantly elevated in the confirmed AHT group across all measured time points.
Conclusions:
- Elevated plasma osteopontin (OPN) levels are strongly associated with confirmed abusive head trauma (AHT) in young children.
- OPN may serve as a valuable biomarker to assist in the identification and triage of suspected AHT cases.
- Further research can explore OPN's role in resource stratification and intervention planning for child abuse victims.
Objective:
To examine levels of plasma osteopontin (OPN), a recently described neuroinflammatory biomarker, in children with abusive head trauma (AHT) compared with children with other types of traumatic brain injury (TBI).
Study Design:
The study cohort comprised children aged <4 years diagnosed with TBI and seen in the intensive care unit in a tertiary children's hospital. Patients were classified as having confirmed or suspected AHT or TBI by other mechanisms (eg, motor vehicle accidents), as identified by a Child Protection Team clinician. Serial blood samples were collected at admission and at 24, 48, and 72 hours after admission. Levels of OPN were compared across groups.
Results:
Of 77 patients identified, 24 had confirmed AHT, 12 had suspected AHT, and 41 had TBI. There were no differences in the Glasgow Coma Scale score between the patients with confirmed AHT and those with suspected AHT and those with TBI (median score, 4.5 vs 4 and 7; P = .39). At admission to the emergency department, OPN levels were significantly higher in children with confirmed AHT compared with the other 2 groups (mean confirmed AHT, 471.5 ng/mL; median suspected AHT, 322.3 ng/mL; mean TBI, 278.0 ng/mL; P = .03). Furthermore, the adjusted mean trajectory levels of OPN were significantly higher in the confirmed AHT group compared with the other 2 groups across all subsequent time points (P = <.01).
Conclusions:
OPN is significantly elevated in children with confirmed AHT compared with those with suspected AHT and those with other types of TBI. OPN expression may help identify children with suspected AHT to aid resource stratification and triage of appropriate interventions for children who are potential victims of abuse.
