Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments
ObjectiveBlood-biomarkers have the potential to aid clinicians in pediatric emergency departments (PED) in managing children with mild traumatic brain injury (mTBI) acutely. However, studies focusing on pediatric populations remain limited. We aim to assess the performances of two routinely used bio...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1518776/full |
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| author | Anne-Cécile Chiollaz Virginie Pouillard Michelle Seiler Céline Habre Fabrizio Romano Céline Ritter Schenck Fabian Spigariol Christian Korff Fabienne Maréchal Verena Wyss Lyssia Gruaz Joan Montaner Jean-Charles Sanchez Sergio Manzano |
| author_facet | Anne-Cécile Chiollaz Virginie Pouillard Michelle Seiler Céline Habre Fabrizio Romano Céline Ritter Schenck Fabian Spigariol Christian Korff Fabienne Maréchal Verena Wyss Lyssia Gruaz Joan Montaner Jean-Charles Sanchez Sergio Manzano |
| author_sort | Anne-Cécile Chiollaz |
| collection | DOAJ |
| description | ObjectiveBlood-biomarkers have the potential to aid clinicians in pediatric emergency departments (PED) in managing children with mild traumatic brain injury (mTBI) acutely. However, studies focusing on pediatric populations remain limited. We aim to assess the performances of two routinely used biomarkers in other fields: the neurofilament light chain protein (NfL), and the N-terminal prohormone of brain natriuretic peptide (NTproBNP), to safely discharge children without intracranial injuries (ICIs).MethodsA prospective multicenter cohort study was conducted, enrolling children suffering from mTBI, both with and without imaging during their acute management in the PED. A blood sample was collected within 24 h post-trauma for biomarker analysis. Inclusion criteria followed the PECARN (Pediatric Emergency Care Applied Research Network) guidelines for the diagnosis of mTBI and for ICI on CT as the primary outcome (CT+).ResultsA total of 302 mTBI patients were analyzed comparing children with ICI (18 CT+) versus all the other children without ICI (54 CT− and 230 in-hospital-observation patients without CT). NfL and NTproBNP were increased in the CT+ group and their performances to safely rule-out patient without ICI reached up to 30% specificity with 100% sensitivity. Equivalent performances were observed whether selecting patients with blood collection within 6 h or 24 h post-trauma.ConclusionNfL and NTproBNP were described for the first time in children suffering mTBI. Their performances were comparable to well-known biomarkers, such as S100b, GFAP, or HFABP, with the benefit of already being used in routine tests for other diseases. Further large-scale studies are necessary to verify and validate these results. |
| format | Article |
| id | doaj-art-7e96486c88f04f8bbd18e8a57c51d6ca |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-7e96486c88f04f8bbd18e8a57c51d6ca2025-01-30T06:22:19ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011610.3389/fneur.2025.15187761518776Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departmentsAnne-Cécile Chiollaz0Virginie Pouillard1Michelle Seiler2Céline Habre3Fabrizio Romano4Céline Ritter Schenck5Fabian Spigariol6Christian Korff7Fabienne Maréchal8Verena Wyss9Lyssia Gruaz10Joan Montaner11Jean-Charles Sanchez12Sergio Manzano13Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, SwitzerlandPediatric Neurology Unit, Woman, Child and Adolescent Department, Geneva University Hospitals, Geneva, SwitzerlandPediatric Emergency Department, University Children's Hospital Zurich, Zurich, SwitzerlandDivision of Radiology, University Hospitals of Geneva, Geneva, SwitzerlandDivision of Pediatric Emergency Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Pediatrics, Fribourg Hospital HFR, Fribourg, SwitzerlandPediatric Emergency Department, Neuchâtel Hospital (RHNE), Neuchatel, SwitzerlandPediatric Neurology Unit, Woman, Child and Adolescent Department, Geneva University Hospitals, Geneva, SwitzerlandPlatform of Pediatric Clinical Research, Woman, Child and Adolescent Department, Geneva University Hospitals, Geneva, SwitzerlandDivision of Pediatric Emergency Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Medicine, Faculty of Medicine, University of Geneva, Geneva, SwitzerlandNeurovascular Research Group, Institute of Biomedicine of Seville IBiS/Virgen Macarena University Hospital/CSIC/University of Seville, Seville, SpainDepartment of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland0Pediatric Emergency Department, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, SwitzerlandObjectiveBlood-biomarkers have the potential to aid clinicians in pediatric emergency departments (PED) in managing children with mild traumatic brain injury (mTBI) acutely. However, studies focusing on pediatric populations remain limited. We aim to assess the performances of two routinely used biomarkers in other fields: the neurofilament light chain protein (NfL), and the N-terminal prohormone of brain natriuretic peptide (NTproBNP), to safely discharge children without intracranial injuries (ICIs).MethodsA prospective multicenter cohort study was conducted, enrolling children suffering from mTBI, both with and without imaging during their acute management in the PED. A blood sample was collected within 24 h post-trauma for biomarker analysis. Inclusion criteria followed the PECARN (Pediatric Emergency Care Applied Research Network) guidelines for the diagnosis of mTBI and for ICI on CT as the primary outcome (CT+).ResultsA total of 302 mTBI patients were analyzed comparing children with ICI (18 CT+) versus all the other children without ICI (54 CT− and 230 in-hospital-observation patients without CT). NfL and NTproBNP were increased in the CT+ group and their performances to safely rule-out patient without ICI reached up to 30% specificity with 100% sensitivity. Equivalent performances were observed whether selecting patients with blood collection within 6 h or 24 h post-trauma.ConclusionNfL and NTproBNP were described for the first time in children suffering mTBI. Their performances were comparable to well-known biomarkers, such as S100b, GFAP, or HFABP, with the benefit of already being used in routine tests for other diseases. Further large-scale studies are necessary to verify and validate these results.https://www.frontiersin.org/articles/10.3389/fneur.2025.1518776/fullblood-biomarkersmTBIpediatricemergencydiagnosis |
| spellingShingle | Anne-Cécile Chiollaz Virginie Pouillard Michelle Seiler Céline Habre Fabrizio Romano Céline Ritter Schenck Fabian Spigariol Christian Korff Fabienne Maréchal Verena Wyss Lyssia Gruaz Joan Montaner Jean-Charles Sanchez Sergio Manzano Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments Frontiers in Neurology blood-biomarkers mTBI pediatric emergency diagnosis |
| title | Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments |
| title_full | Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments |
| title_fullStr | Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments |
| title_full_unstemmed | Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments |
| title_short | Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments |
| title_sort | evaluating nfl and ntprobnp as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments |
| topic | blood-biomarkers mTBI pediatric emergency diagnosis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1518776/full |
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