Difference between revisions of "Traumatic Brain Injury"

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[[File: Release_of_GFAP_after_astrocyte_injury.png|thumb|360px|Release_of_GFAP_after_astrocyte_injury. <ref name="Arti1">Glial Fibrillary Acidic Protein in Blood as a Disease Biomarker of Neuromyelitis Optica Spectrum Disorders. Front. Neurol., 17 March 2022, https://www.frontiersin.org/articles/10.3389/fneur.2022.865730/full#F1</ref>]]
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[[File: Release_of_GFAP_after_astrocyte_injury.png|thumb|360px|Release of GFAP after astrocyte injury. <ref name="Arti1">Glial Fibrillary Acidic Protein in Blood as a Disease Biomarker of Neuromyelitis Optica Spectrum Disorders. Front. Neurol., 17 March 2022, https://www.frontiersin.org/articles/10.3389/fneur.2022.865730/full#F1</ref>]]
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== General information ==
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The theme of SensUs 2023 is Traumatic Brain Injury (TBI). It is often stated in the literature that TBI is a silent epidemic with an estimated 64–74 million new cases presenting each year.<ref name="Arti2">Rattani, A., Gupta, S., Baticulon, R. E., Hung, Y. C., Punchak, M., Agrawal, A., Adeleye, A. O., Shrime, M. G., Rubiano, A. M., Rosenfeld, J. V., & Park, K. B. (2019). Estimating the global incidence of traumatic brain injury. Journal of Neurosurgery, 130(4), 1080–1097. https://doi.org/10.3171/2017.10.jns17352 </ref> The impairments suffered by many TBI patients, such as memory loss, cognitive dysfunction, or behavioural disturbance, are often not visible. The economic and social impact is considerable, with an estimate of direct medical expenditures and indirect costs (e.g., loss of productivity) attributed to TBI exceeding $60 billion in 2000 in the USA. TBI is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force.<ref name="Arti3">Menon, D. K., Schwab, K., Wright, D. W., & Maas, A. I. (2010). Position Statement: Definition of Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 91(11), 1637–1640. https://doi.org/10.1016/j.apmr.2010.05.017 </ref> The severity of injury in TBI is classified as mild, moderate, or severe with mild TBIs being the most common.<ref name="Arti3">Iaccarino, C., Gerosa, A., & Viaroli, E. (2021). Epidemiology of Traumatic Brain Injury. In S. Honeybul & A. G. Kolias (Eds.), Traumatic Brain Injury. Springer. https://link.springer.com/chapter/10.1007/978-3-030-78075-3_1 </ref> Alteration in brain function can be manifest by loss or decreased level of consciousness, alteration in mental state, incomplete memory for the event, or neurological deficits. Examples of external forces include the head striking or being struck by an object, rapid acceleration or deceleration of the brain, penetration of the brain by a foreign object, and exposure to forces associated with blasts.
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GFAP is a protein found in the glial cells of neural tissue. Glial cells are non-neuronal cells that provide physical and metabolic support to neurons. Blood biomarker levels of GFAP reflect acute injury to brain tissue since the biomarker levels increase strongly and fast within hours after the trauma occurred. Therefore, it has potential use in the emergency unit and intensive care unit, directly after the TBI. Furthermore, the biomarker persists for an extended period with a half-life of 48 hours, making it a favourable biomarker to use in both the acute and subacute phases of injury. The concentration of GFAP peaks at about 20 hours after the injury. Reference serum levels of GFAP range from 0.02 — 0.35 𝜇g/L and the cut-off value of a negative CT scan for GFAP is 0.35 𝜇g/L.<ref name="Arti4">Papa, L., Brophy, G. M., Welch, R. D., Lewis, L. M., Braga, C. F., Tan, C. N., Ameli, N. J., Lopez, M. A., Haeussler, C. A., Mendez Giordano, D. I., Silvestri, S., Giordano, P., Weber, K. D., Hill-Pryor, C., & Hack, D. C. (2016). Time Course and Diagnostic Accuracy of Glial and Neuronal Blood Biomarkers GFAP and UCH-L1 in a Large Cohort of Trauma Patients With and Without Mild Traumatic Brain Injury. JAMA Neurology, 73(5), 551. https://doi.org/10.1001/jamaneurol.2016.0039 </ref>
  
  
 
== References ==
 
== References ==
 
<references />
 
<references />

Revision as of 17:19, 4 December 2022

Release of GFAP after astrocyte injury. [1]

General information

The theme of SensUs 2023 is Traumatic Brain Injury (TBI). It is often stated in the literature that TBI is a silent epidemic with an estimated 64–74 million new cases presenting each year.[2] The impairments suffered by many TBI patients, such as memory loss, cognitive dysfunction, or behavioural disturbance, are often not visible. The economic and social impact is considerable, with an estimate of direct medical expenditures and indirect costs (e.g., loss of productivity) attributed to TBI exceeding $60 billion in 2000 in the USA. TBI is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force.[3] The severity of injury in TBI is classified as mild, moderate, or severe with mild TBIs being the most common.[3] Alteration in brain function can be manifest by loss or decreased level of consciousness, alteration in mental state, incomplete memory for the event, or neurological deficits. Examples of external forces include the head striking or being struck by an object, rapid acceleration or deceleration of the brain, penetration of the brain by a foreign object, and exposure to forces associated with blasts.

GFAP is a protein found in the glial cells of neural tissue. Glial cells are non-neuronal cells that provide physical and metabolic support to neurons. Blood biomarker levels of GFAP reflect acute injury to brain tissue since the biomarker levels increase strongly and fast within hours after the trauma occurred. Therefore, it has potential use in the emergency unit and intensive care unit, directly after the TBI. Furthermore, the biomarker persists for an extended period with a half-life of 48 hours, making it a favourable biomarker to use in both the acute and subacute phases of injury. The concentration of GFAP peaks at about 20 hours after the injury. Reference serum levels of GFAP range from 0.02 — 0.35 𝜇g/L and the cut-off value of a negative CT scan for GFAP is 0.35 𝜇g/L.[4]


References

  1. ↑ Glial Fibrillary Acidic Protein in Blood as a Disease Biomarker of Neuromyelitis Optica Spectrum Disorders. Front. Neurol., 17 March 2022, https://www.frontiersin.org/articles/10.3389/fneur.2022.865730/full#F1
  2. ↑ Rattani, A., Gupta, S., Baticulon, R. E., Hung, Y. C., Punchak, M., Agrawal, A., Adeleye, A. O., Shrime, M. G., Rubiano, A. M., Rosenfeld, J. V., & Park, K. B. (2019). Estimating the global incidence of traumatic brain injury. Journal of Neurosurgery, 130(4), 1080–1097. https://doi.org/10.3171/2017.10.jns17352
  3. ↑ 3.0 3.1 Menon, D. K., Schwab, K., Wright, D. W., & Maas, A. I. (2010). Position Statement: Definition of Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 91(11), 1637–1640. https://doi.org/10.1016/j.apmr.2010.05.017 Cite error: Invalid <ref> tag; name "Arti3" defined multiple times with different content
  4. ↑ Papa, L., Brophy, G. M., Welch, R. D., Lewis, L. M., Braga, C. F., Tan, C. N., Ameli, N. J., Lopez, M. A., Haeussler, C. A., Mendez Giordano, D. I., Silvestri, S., Giordano, P., Weber, K. D., Hill-Pryor, C., & Hack, D. C. (2016). Time Course and Diagnostic Accuracy of Glial and Neuronal Blood Biomarkers GFAP and UCH-L1 in a Large Cohort of Trauma Patients With and Without Mild Traumatic Brain Injury. JAMA Neurology, 73(5), 551. https://doi.org/10.1001/jamaneurol.2016.0039
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