Prediction of Neurocognitive Outcome after Moderate-Severe Traumatic Brain Injury Using Serum Neuron-Specific Enolase and S100 biomarkers
Authors: Slavoaca Dana ,   Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania,   “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania, Birle Codruta ,   Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania,   “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,   Codruta Birle, MD 37 Mircea Eliade Street,Cluj-Napoca, Romania, 400364 E-mail: adicodruta@yahoo.com, Stan Adina ,   Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania,   “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania, Tatomir Alexandru ,   Department of Neurology, University of Maryland, School of Medicine, Baltimore, United States of America, Popa Oana ,   Neurology Clinic, Cluj Emergency County Hospital, Cluj-Napoca, Romania, Rosu Paula ,   Neurology Clinic, Cluj Emergency County Hospital, Cluj-Napoca, Romania, Vulcan Ana-Maria ,   Neurology Clinic, Cluj Emergency County Hospital, Cluj-Napoca, Romania, Chira Diana ,   “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania, Popa Livia Livint ,   Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania,   “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania, Dina Constantin ,   Department of Radiology, “Ovidius” University, Faculty of Medicine, Constanta, Romania, Vacaras Vitalie ,   Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania,   “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,   Neurology Clinic, Cluj Emergency County Hospital, Cluj-Napoca, Romania, Strilciuc Stefan ,   Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania,   “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania, Vos Pieter ,   Department of Neurology, Slingeland Hospital, Doetinchem, The Netherlands
Published: November 2022

Seric biomarkers have been tested in a large number of studies on traumatic brain injuries (TBI) patients in order to predict severity, especially related to the short-term outcome. However, TBI patients have a high risk of developing long-term complications such as physical disability, cognitive impairment, psychiatric pathology, epilepsy, and others.
The aim of this study was to assess the correlation between protein biomarkers S100 and neuron-specific enolase (NSE) and neurocognitive status at 10- and 90-days post-injury.
Both biomarkers were tested in the first 4h and after 72h post-injury in 62 patients with moderate-severe TBI. The patients were evaluated by a series of neurocognitive tests: Early Rehabilitation Barthel Index (ERBI), Glasgow Outcome Scale-Extended (GOSE), The Mini-Mental State Examination (MMSE), Processing Speed Index (PSI), and Stroop Test, at 10 and 90 days post-injury and supplementary by the Hospital Anxiety and Depression Scale at 90 days. For evaluating the whole neurocognitive status instead of every scale separately, we used Structural Equation Modeling (SEM), while for anxiety and depressive symptoms, we used multiple regression analyses. SEM showed that NSE values at 4 hours were significant predictors of the cognitive status at 10 (p=0.034) and 90 days (p= 0.023). Also, there were found significant correlations between NSE at 4h and the anxiety level. This study demonstrated a significant correlation between NSE at 4h and short and medium-term neuropsychological outcomes, which recommends using this biomarker for selecting patients with a higher risk of cognitive dysfunction.