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Diagnostic Value of Neuron-specific Enolase in Patients with Traumatic Brain Injury Referring to Emergency Departments in 2015-2016

Document Type : Short Communication

Authors

Trauma Research Center, AJA University of Medical Sciences, Tehran, Iran

Abstract

Background: The aim of the present study was to determine the optimal cut-off point ofneuron-specific enolase (NSE) level for diagnosis of brain damage in patients with head trauma.
Methods: This cross-sectional study was conducted on 150 patients with traumatic brain injuries (TBIs) who referred to the Emergency Department of Besat Hospital in Tehran, Iran, during 2015-2016. The neuron specific enolase (NSE) serum level was measured by obtaining peripheral blood samples from the participants at two stages, namely upon admission (i.e., the first stage) and 6 h after admission (i.e., the second stage). To determine the best NSE cut-off point, diagnostic indices, such as sensitivity and specificity, as well as positive and negative predictive values, were used by applying the performance curve. Data were analyzed using MedCalc software (version 13.3).
Results: The mean NSE serum levels of the subjects were 16.66 ± 11.32 and 17.92 ± 12.49 at the first and second stages of the study, respectively. The sensitivity and specificity of NES were respectively calculated as 1 and 0.92 at the beginning of the study. In addition, NSE showed significant direct and indirect relationships with computed tomography (CT) scan results and Glasgow Coma Scale (GCS) scores, respectively (P < 0.001).
Conclusion: Considering the NSE cut-off points in the present study, NSE values can be used to determine the brain damage in patients with head trauma based on gender and age group. The NSE showed a high sensitivity and specificity. In addition, an inverse correlation was observed between NSE level and GCS score.

Keywords

References
  1. Moore L, Evans D, Hameed SM, Yanchar NL, Stelfox HT, Simons R, et al. Mortality in Canadian Trauma Systems. Annals of surgery. 2017;265(1):212-7.
  2. Zia N, Mehmood A, Namaganda RH, Ssenyonjo H, Kobusingye O, Hyder AA. Causes and outcomes of traumatic brain injuries in Uganda: analysis from a pilot hospital registry. Trauma surgery & acute care open. 2019;4(1):e000259.
  3. Solani Z, Khaksari hadad M, Sarkaki AR. The Role of Proinflammatory Cytokines in Mediation of Brain Antiedema Effect of Female Sex Steroids Following Traumatic Brain Injury. Journal of Kerman University of Medical Sciences. 2011;18(2):107-22.
  4. Nikbakht F, Shahedi A, Sheibani V, Najafipour H, Moshtaghie G. The Effect of Enalapril on Brain Edema and Cytokine Production Following Transient Focal Cerebral Ischemia in Mice. Journal of Kerman University of Medical Sciences. 2008;15(3):195-205.
  5. Rutland-Brown W, Langlois JA, Thomas KE, Xi YL. Incidence of traumatic brain injury in the United States, 2003. The Journal of head trauma rehabilitation. 2006;21(6):544-8.
  6. Aghakhani N, Azami M, Jasemi M, Khoshsima M, Eghtedar S, Rahbar N. Epidemiology of traumatic brain injury in urmia, iran. Iranian Red Crescent Medical Journal. 2013;15(2):173.
  7. Kavosi Z, Jafari A, Hatam N, Enaami M. The economic burden of traumatic brain injury due to fatal traffic accidents in shahid rajaei trauma hospital, shiraz, iran. Archives of trauma research. 2015;4(1).
  8. Fountain DM, Kolias AG, Laing RJ, Hutchinson PJ. The financial outcome of traumatic brain injury: a single centre study. British journal of neurosurgery. 2017;31(3):350-5.
  9. Dombovy ML. Traumatic brain injury. Continuum: lifelong learning in neurology. 2011;17(3, Neurorehabilitation):584-605.
  10. Wijdicks EF, Rabinstein AA, Bamlet WR, Mandrekar JN. FOUR score and Glasgow Coma Scale in predicting outcome of comatose patients: a pooled analysis. Neurology. 2011;77(1):84-5.
  11. Fischer M, Rüegg S, Czaplinski A, Strohmeier M, Lehmann A, Tschan F, et al. Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients: a prospective observational study. Critical care. 2010;14(2):R64.
  12. Saatman KE, Duhaime A-C, Bullock R, Maas AI, Valadka A, Manley GT. Classification of traumatic brain injury for targeted therapies. Journal of neurotrauma. 2008;25(7):719-38.
  13. Borg J, Holm L, Cassidy JD, Peloso P, Carroll L, Von Holst H, et al. Diagnostic procedures in mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of rehabilitation medicine. 2004;36(0):61-75.
  14. Joseph B, Pandit V, Aziz H, Kulvatunyou N, Zangbar B, Green DJ, et al. Mild traumatic brain injury defined by Glasgow Coma Scale: Is it really mild? Brain injury. 2015;29(1):11-6.
  15. Rodríguez-Rodríguez A, Egea-Guerrero JJ, Gordillo-Escobar E, Enamorado-Enamorado J, Hernández-García C, Ruiz de Azúa-López Z, et al. S100B and Neuron-Specific Enolase as mortality predictors in patients with severe traumatic brain injury. Neurological research. 2016;38(2):130-7.
  16. Gradisek P, Osredkar J, Korsic M, Kremzar B. Multiple indicators model of long-term mortality in traumatic brain injury. Brain Injury. 2012;26(12):1472-81.
  17. Meric E, Gunduz A, Turedi S, Cakir E, Yandi M. The prognostic value of neuron-specific enolase in head trauma patients. The Journal of emergency medicine. 2010;38(3):297-301.
  18. Li X-Y, Feng D-F. Diffuse axonal injury: novel insights into detection and treatment. Journal of Clinical Neuroscience. 2009;16(5):614-9.
  19. Al Nimer F, Thelin E, Nyström H, Dring AM, Svenningsson A, Piehl F, et al. Comparative assessment of the prognostic value of biomarkers in traumatic brain injury reveals an independent role for serum levels of neurofilament light. PloS one. 2015;10(7):e0132177.
  20. Stein DM, Lindell AL, Murdock KR, Kufera JA, Menaker J, Bochicchio GV, et al. Use of serum biomarkers to predict cerebral hypoxia after severe traumatic brain injury. Journal of neurotrauma. 2012;29(6):1140-9.
  21. Böhmer AE, Oses JP, Schmidt AP, Perón CS, Krebs CL, Oppitz PP, et al. Neuron-specific enolase, S100B, and glial fibrillary acidic protein levels as outcome predictors in patients with severe traumatic brain injury. Neurosurgery. 2011;68(6):1624-31.
  22. Olivecrona M, Rodling-Wahlström M, Naredi S, Koskinen LD. S-100B and neuron specific enolase are poor outcome predictors in severe traumatic brain injury treated by an intracranial pressure targeted therapy. Journal of Neurology, Neurosurgery & Psychiatry. 2009;80(11):1241-8.
  23. De Kruijk J, Leffers P, Menheere P, Meerhoff S, Twijnstra A. S‐100B and neuron‐specific enolase in serum of mild traumatic brain injury patients A comparison with healthy controls. Acta neurologica scandinavica. 2001;103(3):175-9.
  24. Ebrahimi FH, Moshiri E, Zand S. An Investigation On Quality Of Emergency Care Of Head Iinjury Patients In Emergrncy Ward, Vali-e-Asr Hospital, Arak 2005. 2008.
  25. Azimiyan J, Abdi M, Moradi M, Alipour M. The Effect of Foot Massage on the Consciousness Levels in Comatose Patients With Brain Injury Hospitalized in Intensive Care Unit (Icu): A Randomised Control Trial. Journal of Knowledge & Health. 2015;10(3):25-30.
  26. Meric E, Gunduz A, Turedi S, Cakir E, Yandi M. The prognostic value of neuron-specific enolase in head trauma patients. Journal of Emergency Medicine. 2010;38(3):297-301.
  27. Fridriksson T, Kini N, Walsh‐Kelly C, Hennes H. Serum Neuron‐specific Enolase as a Predictor of Intracranial Lesions in Children with Head Trauma: A Pilot Study. Academic Emergency Medicine. 2000;7(7):816-20.
  28. Kirchhoff C, Buhmann S, Braunstein V, Leidel B, Vogel T, Kreimeier U, et al. Cerebrospinal s100-B: a potential marker for progressive intracranial hemorrhage in patients with severe traumatic brain injury. Eur J Med Res. 2008;13(11):511-6.
  29. Hayakata T, Shiozaki T, Tasaki O, Ikegawa H, Inoue Y, Toshiyuki F, et al. Changes in CSF S100B and cytokine concentrations in early-phase severe traumatic brain injury. Shock. 2004;22(2):102-7.
  30. Berger RP, Adelson PD, Richichi R, Kochanek PM. Serum biomarkers after traumatic and hypoxemic brain injuries: insight into the biochemical response of the pediatric brain to inflicted brain injury. Developmental neuroscience. 2006;28(4-5):327-35.
  31. Bakay R, Sweeney KM, Wood JH. Pathophysiology of cerebrospinal fluid in head injury: Part 2. Biochemical markers for central nervous system trauma. Neurosurgery. 1986;18(3):376-82.
  32. Schoerkhuber W, Kittler H, Sterz F, Behringer W, Holzer M, Frossard M, et al. Time course of serum neuron-specific enolase: a predictor of neurological outcome in patients resuscitated from cardiac arrest. Stroke. 1999;30(8):1598-603.
  33. Berger RP, Hayes RL, Richichi R, Beers SR, Wang KK. Serum concentrations of ubiquitin C-terminal hydrolase-L1 and αII-spectrin breakdown product 145 kDa correlate with outcome after pediatric TBI. Journal of neurotrauma. 2012;29(1):162-7.
  34. Sogut O, Guloglu C, Orak M, Sayhan M, Gokdemir M, Ustundag M, et al. Trauma scores and neuron-specific enolase, cytokine and C-reactive protein levels as predictors of mortality in patients with blunt head trauma. Journal of International Medical Research. 2010;38(5):1708-20.
  35. Vos PE, Lamers K, Hendriks J, Van Haaren M, Beems T, Zimmerman C, et al. Glial and neuronal proteins in serum predict outcome after severe traumatic brain injury. Neurology. 2004;62(8):1303-10.
  36. Ross S, Cunningham R, Johnston C, Rowlands B. Neuron-specific enolase as an aid to outcome prediction in head injury. British journal of neurosurgery. 1996;10(5):471-6.
  37. Raabe A, Grolms C, Seifert V. Serum markers of brain damage and outcome prediction in patients after severe head injury. British journal of neurosurgery. 1999;13(1):56-9.
  38. Zaheer S, Beg M, Rizvi I, Islam N, Ullah E, Akhtar N. Correlation between serum neuron specific enolase and functional neurological outcome in patients of acute ischemic stroke. Annals of Indian Academy of Neurology. 2013;16(4):504.
  39. Brea D, Sobrino T, Blanco M, Cristobo I, Rodríguez-González R, Rodríguez-Yañez M, et al. Temporal profile and clinical significance of serum neuron-specific enolase and S100 in ischemic and hemorrhagic stroke. Clinical chemistry and laboratory medicine. 2009;47(12):1513-8.
  40. Guan W, Yang Y, Xia W, Li L, Gong D. Significance of serum neuron-specific enolase in patients with acute traumatic brain injury. Chinese journal of traumatology= Zhonghua chuang shang za zhi. 2003;6(4):218-21.
Journal of Kerman University of Medical Sciences
Volume 28, Issue 3
May and June 2021
Pages 319-329
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