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Serum Neuroglobin in Acute Traumatic Brain Injury in Children: A Multicenter Case-Control Study
Khaled Saad1, Hala S M Abdelmotogaly2, Amira H El-Ashry3
1Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
Insights
Serum neuroglobin levels rise in children after traumatic brain injury (TBI), peaking at 24 hours. Higher levels correlate with TBI severity and predict poor outcomes, aiding early risk assessment.
Area of Science:
- Pediatric neurology
- Biomarker research
- Trauma care
Background:
- Traumatic brain injury (TBI) is a major cause of death and disability in children.
- Early identification of TBI severity and prognosis is crucial for effective management.
- Neuroglobin, an oxygen-binding protein, is implicated in neuroprotection.
Purpose of the Study:
- To investigate the temporal changes of serum neuroglobin in pediatric TBI patients.
- To assess neuroglobin's utility as a biomarker for TBI severity.
- To evaluate neuroglobin's predictive value for clinical outcomes in children post-TBI.
Main Methods:
- A multicenter case-control study involving 110 children with TBI and 100 healthy controls.
- Serum neuroglobin measured by ELISA at admission, 24 hours, and 72 hours post-TBI.
- Analysis of neuroglobin kinetics against Glasgow Coma Scale scores and 6-month Glasgow Outcome Scale.
Main Results:
- Serum neuroglobin was significantly elevated in TBI children compared to controls.
- Neuroglobin levels peaked at 24 hours post-TBI and decreased by 72 hours.
- Peak neuroglobin inversely correlated with Glasgow Coma Scale scores and predicted poor 6-month outcomes (AUC=0.89).
Conclusions:
- Serum neuroglobin is a potential early prognostic biomarker for pediatric TBI.
- Its dynamic changes and correlation with severity support its role in risk stratification.
- Neuroglobin shows promise for predicting functional outcomes in children after TBI.
Background And Objectives:
Traumatic brain injury (TBI) represents a significant cause of morbidity and mortality in children. This study aimed to delineate the temporal profile of serum neuroglobin in children after TBI and to evaluate its utility as a potential biomarker for assessing TBI severity and predicting clinical outcomes in pediatric age groups.
Methods:
A multicenter case-control study was conducted involving 110 children with TBI (≤18 years) admitted to 5 tertiary-care hospitals in Egypt. The study included 100 healthy children as a control group. Serum neuroglobin concentrations were measured using enzyme-linked immunosorbent assay at 3 time points: on admission and at 24 and 72 hours thereafter. The temporal kinetics of serum neuroglobin were analyzed in relation to admission Glasgow Coma Scale scores and clinical outcomes assessed 6 months after trauma using the Glasgow Outcome Scale.
Results:
Serum neuroglobin levels were significantly higher in children with TBI than in controls at admission (P < .001), reached the highest levels at 24 hours postinjury (P < .001), and then declined by 72 hours. Peak serum neuroglobin showed a significant inverse correlation with Glasgow Coma Scale scores (P < .0001), indicating higher levels in more severe injuries. Receiver operating characteristic analysis revealed that peak neuroglobin is a strong predictor of poor outcomes, with area under the curve of 0.89.
Conclusion:
Serum neuroglobin appears to be a promising early prognostic biomarker in pediatric patients with TBI. This preliminary study supports its potential role in early risk stratification. Its rapid rise with a peak at 24 hours postinjury, together with its association with 6-month functional outcomes, supports its potential role in early risk stratification and outcome prediction.
