PMID- 37360545
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230701
IS  - 2689-288X (Electronic)
IS  - 2689-288X (Linking)
VI  - 4
IP  - 1
DP  - 2023
TI  - Evaluating Targeted Therapeutic Response With Predictive Blood-Based Biomarkers 
      in Patients With Chronic Mild Traumatic Brain Injury.
PG  - 404-409
LID - 10.1089/neur.2023.0003 [doi]
AB  - Chronic consequences of mild traumatic brain injury (mTBI) are heterogeneous, but 
      may be treatable with targeted medical and rehabilitation interventions. A 
      biological signature for the likelihood of response to therapy (i.e., 
      "predictive" biomarkers) would empower personalized medicine post-mTBI. The 
      purpose of this study was to correlate pre-intervention blood biomarker levels 
      and the likelihood of response to targeted interventions for patients with 
      chronic issues attributable to mTBI. Patients with chronic symptoms and/or 
      disorders secondary to mTBI >3 months previous (104 days to 15 years; n = 74) 
      were enrolled. Participants completed pre-intervention assessments of symptom 
      burden, comprehensive clinical evaluation, and blood-based biomarker 
      measurements. Multi-domain targeted interventions for specific symptoms and 
      impairments across a 6-month treatment period were prescribed. Participants 
      completed a follow-up testing after the treatment period. An all-possible model's 
      backward logistic regression was built to identify predictors of improvement in 
      relation to blood biomarker levels before intervention. The minimum clinically 
      important difference (MCID) of the change score (post-intervention subtracted 
      from pre-intervention) for the Post-Concussion Symptom Scale (PCSS) to identify 
      treatment responders from non-responders was the primary outcome. The MCID for 
      total PCSS score was 10. The model to predict change in PCSS score over the 
      6-month intervention was significant (R(2) = 0.09; p = 0.01) and identified 
      ubiquitin C-terminal hydrolase L1 (odds ratio [OR] = 2.53; 95% confidence 
      interval [CI], 1.18-5.46; p = 0.02) and hyperphosphorylated tau (p-tau; 
      OR = 0.70; 95% CI, 0.51-0.96; p = 0.03) as significant predictors of symptom 
      improvement beyond the PCSS MCID. In this cohort of chronic TBI subjects, blood 
      biomarkers before rehabilitation intervention predicted the likelihood of 
      response to targeted therapy for chronic disorders post-TBI.
CI  - (c) Shawn R. Eagle et al., 2023; Published by Mary Ann Liebert, Inc.
FAU - Eagle, Shawn R
AU  - Eagle SR
AD  - Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Puccio, Ava M
AU  - Puccio AM
AD  - Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Agoston, Denes V
AU  - Agoston DV
AD  - School of Medicine, Uniformed Services University of the Health Sciences, 
      Bethesda, Maryland, USA.
FAU - Soose, Ryan
AU  - Soose R
AD  - Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, 
      USA.
FAU - Mancinelli, Michael
AU  - Mancinelli M
AD  - Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Nwafo, Rachel
AU  - Nwafo R
AD  - Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - McIntyre, Peyton
AU  - McIntyre P
AD  - Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Agnone, Allison
AU  - Agnone A
AD  - Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Tollefson, Savannah
AU  - Tollefson S
AD  - Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Collins, Michael
AU  - Collins M
AD  - Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Kontos, Anthony P
AU  - Kontos AP
AD  - Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Schneider, Walter
AU  - Schneider W
AD  - Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, 
      USA.
FAU - Okonkwo, David O
AU  - Okonkwo DO
AD  - Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
LA  - eng
PT  - Journal Article
DEP - 20230622
PL  - United States
TA  - Neurotrauma Rep
JT  - Neurotrauma reports
JID - 101773091
PMC - PMC10288300
OTO - NOTNLM
OT  - UCH-L1
OT  - chronic mTBI
OT  - p-tau
OT  - predictive biomarkers
OT  - targeted treatment
COIS- No competing financial interests exist.
EDAT- 2023/06/26 19:07
MHDA- 2023/06/26 19:08
PMCR- 2023/06/22
CRDT- 2023/06/26 12:38
PHST- 2023/06/26 19:08 [medline]
PHST- 2023/06/26 19:07 [pubmed]
PHST- 2023/06/26 12:38 [entrez]
PHST- 2023/06/22 00:00 [pmc-release]
AID - 10.1089/neur.2023.0003 [pii]
AID - 10.1089/neur.2023.0003 [doi]
PST - epublish
SO  - Neurotrauma Rep. 2023 Jun 22;4(1):404-409. doi: 10.1089/neur.2023.0003. 
      eCollection 2023.