Acta Neurochirurgica

, Volume 152, Issue 1, pp 1–17

Update on protein biomarkers in traumatic brain injury with emphasis on clinical use in adults and pediatrics


  • Erzsébet Kövesdi
    • Department of NeurosurgeryUniversity of Pécs
  • János Lückl
    • Department of NeurologyUniversity of Pennsylvania
  • Péter Bukovics
    • Department of NeurosurgeryUniversity of Pécs
    • Neurobiology Research Group of the Hungarian Academy of Sciences
  • Orsolya Farkas
    • Department of NeurosurgeryUniversity of Pécs
  • József Pál
    • Department of NeurosurgeryUniversity of Pécs
  • Endre Czeiter
    • Department of NeurosurgeryUniversity of Pécs
  • Dóra Szellár
    • Department of NeurosurgeryUniversity of Pécs
  • Tamás Dóczi
    • Department of NeurosurgeryUniversity of Pécs
  • Sámuel Komoly
    • Department of NeurologyUniversity of Pécs
    • Department of NeurosurgeryUniversity of Pécs
Review Article

DOI: 10.1007/s00701-009-0463-6

Cite this article as:
Kövesdi, E., Lückl, J., Bukovics, P. et al. Acta Neurochir (2010) 152: 1. doi:10.1007/s00701-009-0463-6



This review summarizes protein biomarkers in mild and severe traumatic brain injury in adults and children and presents a strategy for conducting rationally designed clinical studies on biomarkers in head trauma.


We performed an electronic search of the National Library of Medicine’s MEDLINE and Biomedical Library of University of Pennsylvania database in March 2008 using a search heading of traumatic head injury and protein biomarkers. The search was focused especially on protein degradation products (spectrin breakdown product, c-tau, amyloid-β1–42) in the last 10 years, but recent data on “classical” markers (S-100B, neuron-specific enolase, etc.) were also examined.


We identified 85 articles focusing on clinical use of biomarkers; 58 articles were prospective cohort studies with injury and/or outcome assessment.


We conclude that only S-100B in severe traumatic brain injury has consistently demonstrated the ability to predict injury and outcome in adults. The number of studies with protein degradation products is insufficient especially in the pediatric care. Cohort studies with well-defined end points and further neuroproteomic search for biomarkers in mild injury should be triggered. After critically reviewing the study designs, we found that large homogenous patient populations, consistent injury, and outcome measures prospectively determined cutoff values, and a combined use of different predictors should be considered in future studies.


ReviewMildSeverePediatricTraumatic brain injuryBiomarkersOutcome

Copyright information

© Springer-Verlag 2009