Citation

Juengst SB, Kumar RG, Failla MD, Goyal A, Wagner AK. J. Head Trauma Rehabil. 2014; 30(3): 207-218.

Affiliation

Department of Physical Medicine and Rehabilitation (Drs Juengst and Wagner, Messrs Kumar and Goyal, and Ms Failla), Center for Neuroscience (Ms Failla and Dr Wagner), and Safar Center for Resuscitation Research, (Dr Wagner), University of Pittsburgh, Pittsburgh, Pennsylvania.

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000031

PMID

24590155

Abstract

OBJECTIVE:: To examine whether acute inflammation profiles predict posttraumatic depression (PTD) risk 6 and 12 months after traumatic brain injury. SETTING:: University-affiliated level 1 trauma center and community. PARTICIPANTS:: Adults with moderate to severe traumatic brain injury (acute serum levels: n = 50; acute cerebrospinal fluid (CSF) levels: n = 41). DESIGN:: Prospective cohort study. MAIN MEASURES:: Patient Health Questionnaire; inflammatory biomarkers (interleukin [IL]-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, tumor necrosis factor α, soluble vascular adhesion molecule [sVCAM-1], soluble intracellular adhesion molecule [sICAM-1], soluble Fas [sFAS]). RESULTS:: Higher levels of acute CSF cytokine surface markers (sVCAM-1, sICAM-1, and sFAS) in an inflammatory biomarker risk (IBR) score were associated with a 3.920-fold increase in the odds of developing PTD at 6 months (95% confidence interval: 1.163-8.672). Having sICAM-1, sVCAM-1, or sFAS above the 75th percentile had a positive predictive value of 85.7% for PTD risk at 6 months. An IBR score including inflammatory biomarkers IL-7 and IL-8 showed a trending association with 12-month PTD risk (odds ratio = 3.166, 95% confidence interval: 0.936-10.708). CONCLUSION:: Acute CSF IBR scores show promise for identifying individuals at risk for PTD. Further research should assess acute CSF inflammatory biomarkers' relationships to chronic inflammation as a mechanism of PTD and should explore anti-inflammatory treatments for PTD, as well as prevention and screening protocols, and link inflammatory biomarkers to symptom tracking.

Language: en