Advances in biomarkers for diagnosing and prognosticating disorders of consciousness

Disorders of Consciousness (DoC) resulting from brain injury comprise a spectrum of clinical syndromes, where the level of impairment varies considerably depending on lesion location, etiology, severity, and individual patient factors. These differences substantially influence both rehabilitation strategies and long-term prognosis. Current diagnostic assessment relies primarily on behavioral scales, supplemented by electrophysiological and neuroimaging studies; however, these approaches remain limited in objectivity, sensitivity, and accessibility. There is therefore a clinical need for biologically informative biomarkers to improve diagnostic precision and prognostic stratification in DoC. This narrative review synthesizes recent advances in biomarker research, encompassing proteomic, metabolomic, and microRNAs (miRNAs) signatures, across multiple biological specimens. We evaluate the findings spanning exploratory to validation stages, and discuss their translational potential, providing a valuable reference for future large-scale, multicenter investigations.