Diagnosis of brain injury and functional prognosis prediction with blood biomarkers in mild traumatic brain injury patients

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K10725
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Neurosurgery
• Research Institution: Yamaguchi University
• Principal Investigator: SUEHIRO Eiichi 山口大学, 医学部附属病院, 助教 (10363110)
• Co-Investigator(Kenkyū-buntansha): 鈴木 倫保 山口大学, 大学院医学系研究科, 教授 (80196873)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 軽症頭部外傷 / 血清バイオマーカー / Dダイマー / 組織因子 / 高次脳機能

Outline of Final Research Achievements

In this study, the serum values of D-dimer were investigated as blood biomarkers for detection of structural disorder in mild traumatic brain injury without CT scans. The value of D-dimer on admission was significantly higher (19.5 μg/ml vs 1.1μg/ml) in the lesion(+) group. The sensitivity and specificity were 0.91 and 0.90 at a D-dimer cutoff of 1.7 μg/ml. Abnormal findings of higher brain function were not obtained in this study. The examinations between biomarker and function could not be performed. A significant correlation between NSE and D-dimer was seen on admittance. Furthermore, a significant correlation between soluble tissue factor and D-dimer was seen on admittance. The blood level of D-dimer accurately reflected the degree of brain tissue damage indicated by NSE levels. Our data suggest that the release of tissue factor induced by brain tissue damage may activate the coagulation cascade leading to elevation in D-dimer levels.

Free Research Field

神経外傷

Academic Significance and Societal Importance of the Research Achievements

頭部外傷における脳損傷の程度を血清D-dimer値の測定にて数値化することが可能となった。また、組織因子による上昇機序を示すことにより信用性も増した。D-dimerの測定は、日本では日常的に可能な検査である。中枢神経領域の診察や画像診断は、非専門医にとっては、苦手意識もあり敬遠されがちである。D-dimerの測定は、非専門医にとっても頭部外傷の診断が容易に可能となるtoolと成り得る。