Biomarkers for
Traumatic Brain Injury
______
Megan Snair, Chanel Matney, and
Katherine Bowman, Rapporteurs
Forum on Traumatic Brain Injury
Board on Health Sciences Policy
Health and Medicine Division
Proceedings of a Workshop
NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by contracts and grants between the National Academy of Sciences and Abbott Laboratories, AARP, Centers for Disease Control and Prevention (contract 200-2011-38807, task order 75D30121F00097), Department of Defense (contract W81XWH22C0033), National Highway Traffic Safety Administration (contract 693JJ922P000036), National Institute on Disability, Independent Living, and Rehabilitation Research (contract HHSP233201400020B, task order 75P00122F37113), National Institutes of Health (contract HHSN263201800029I, task order 75N98022F00001), and Department of Veterans Affairs (contract 36C24E22P0005). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-70164-8
International Standard Book Number-10: 0-309-70164-3
Digital Object Identifier: https://doi.org/10.17226/26932
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2023. Biomarkers for traumatic brain injury: Proceedings of a workshop.
Washington, DC: The National Academies Press. https://doi.org/10.17226/26932.
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PLANNING COMMITTEE ON BIOMARKERS FOR TRAUMATIC BRAIN INJURY1
JEFFREY BAZARIAN, Professor, Department of Emergency Medicine, University of Rochester Medical Center, New York
RAMON DIAZ-ARRASTIA, John McCrea Dickson, MD Professor of Neurology, and Director, Clinical TBI Research Center, University of Pennsylvania Perelman School of Medicine and Penn Presbyterian Medical Center, Pennsylvania
STUART HOFFMAN, Senior Health Science Officer for Traumatic Brain Injury, Department of Veterans Affairs, Washington, DC
FREDERICK KORLEY, Associate Professor, Department of Emergency Medicine, University of Michigan
GEOFFREY MANLEY, Margaret Liu Endowed Professorship in Traumatic Brain Injury, Professor and Vice Chairman of Neurological Surgery, and Codirector, UCSF Brain and Spinal Injury Center, University of California, San Francisco, and Chief of Neurosurgery, Zuckerberg San Francisco General Hospital, California
LUCA MARINELLI, Senior Principal Scientist, Biology and Applied Physics, GE Research, New York
BETH McQUISTON, Medical Director, Medical and Scientific Affairs, Abbott Diagnostics, Abbott Laboratories, Illinois
LESLIE PRICHEP, Chief Scientific Officer, BrainScope Company, Inc., Maryland
Health and Medicine Division Staff
KATHERINE BOWMAN, Director, Forum on Traumatic Brain Injury
CHANEL MATNEY, Program Officer (from September 2022)
VICTORIA CHEGE, Senior Program Assistant
CLARE STROUD, Senior Director, Board on Health Sciences Policy
Consultants
MEGAN SNAIR, Science Writer, SGNL Solutions, LLC
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1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
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FORUM ON TRAUMATIC BRAIN INJURY1
DONALD BERWICK (Chair), Institute for Healthcare Improvement
ALEXANDER BALBIR, Wounded Warrior Project
RACHAEL BARRETT, The Elizabeth Dole Foundation
JOE BONNER, Eunice Kennedy Shriver National Institute of Child Health and Human Development
MATTHEW BREIDING, Centers for Disease Control and Prevention
JAVIER CARDENAS, Barrow Concussion and Brain Injury Center; American Academy of Neurology
NANCY CHOCKLEY, National Institute for Health Care Management Foundation
JOHN CORRIGAN, The Ohio State University Wexner Medical Center; Brain Injury Association of America
RAMON DIAZ-ARRASTIA, University of Pennsylvania Perelman School of Medicine
E. WESLEY ELY, Vanderbilt University Medical Center
BRUCE EVANS, Upper Pine River Fire Protection District; National Association of Emergency Medical Technicians
JONATHAN FISHER, American College of Emergency Physicians
STEVEN FLANAGAN, NYU Grossman School of Medicine; American Academy of Physical Medicine and Rehabilitation
BRIAN HAINLINE, National Collegiate Athletic Association
ODETTE HARRIS, Stanford University School of Medicine
STUART HOFFMAN, Department of Veterans Affairs
RICHARD HODES, National Institute on Aging
FREDERICK KORLEY, University of Michigan
WALTER KOROSHETZ, National Institute of Neurological Disorders and Stroke
KATHY LEE, Department of Defense
RACHEL LAZARUS, AARP
D. CARL LONG, NeuroTrama Sciences, LLC
TARA JO MANAL, American Physical Therapy Association
GEOFFREY MANLEY, University of California, San Francisco
LUCA MARINELLI, GE Research
CHRISTINA L. MASTER, Children’s Hospital of Philadelphia, University of Pennsylvania
BETH McQUISTON, Abbott Laboratories
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1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
CATE MILLER, National Institute on Disability, Independent Living, and Rehabilitation Research
CHRIS NOWINSKI, Concussion Legacy Foundation
KAREN O’CONNELL, Northern Kentucky University; Emergency Nurses Association
TESSIE OCTOBER, Eunice Kennedy Shriver National Institute of Child Health and Human Development
DAVID OKONKWO, University of Pittsburgh School of Medicine
TOLU O. OYESANYA, Duke University
CORINNE PEEK-ASA, University of California, San Diego
LESLIE PRICHEP, BrainScope Company, Inc.
TERRY RAUCH, Department of Defense
JOEL SCHOLTEN, Department of Veterans Affairs
DEBORAH M. STEIN, American College of Surgeons Committee on Trauma
SHELLY TIMMONS, Indiana University School of Medicine; American Association of Neurological Surgeons
GAMUNU WIJETUNGE, National Highway Traffic Safety Administration
REBECCAH WOLFKIEL, National Association of State Head Injury Administrators
KRISTINE YAFFE, University of California, San Francisco
Forum Staff
KATHERINE BOWMAN, Forum Director
CHANEL MATNEY, Program Officer (from September 2022)
VICTORIA CHEGE, Senior Program Assistant
CHRISTIE BELL, Finance Business Partner
CLARE STROUD, Senior Director, Board on Health Sciences Policy
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
RACHEL LAZARUS, AARP
ANGELA LUMBA-BROWN, Stanford University
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings, nor did they see the final draft before its release. The review of this proceedings was overseen by DOUGLAS SMITH, University of Pennsylvania. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies. We also thank staff member MEREDITH YOUNG for reading and providing helpful comments on this manuscript.
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4INCORPORATING BIOMARKERS INTO RESEARCH AND CLINICAL PRACTICE
Use of Pharmacodynamic Response Biomarkers in Preclinical TBI Research
Improving Diagnosis and Envisioning the Future of TBI Care
Opportunities to Advance the Use of Biomarkers in TBI Classification
Where TBI Biomarkers Can Currently Have Impact
Potential Next Steps and Opportunities Identified by Participants
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Acronyms and Abbreviations
BARDA | Biomedical Advanced Research and Development Authority |
CARE | Concussion Assessment, Research and Education Consortium |
CT | computed tomography |
DoD | Department of Defense |
ED | emergency department |
EEG | electroencephalogram |
EMS | emergency medical services |
EPB41 | erythrocyte membrane protein band 4.1 |
FDA | Food and Drug Administration |
GFAP | glial fibrillary acidic protein |
HRV | heart rate variability |
ICU | intensive care unit |
MI | myocardial infarction |
MRI | magnetic resonance imaging |
NfL | neurofilament light chain |
NIH | National Institutes of Health |
OBTT | Operation Brain Trauma Therapy |
PET | positron emission tomography |
PLR | pupillary light reflex |
PRECISE-TBI | Pre-Clinical Interagency Research Resource-TBI |
PSA | prostate-specific antigen |
RCT | randomized controlled trial |
S100B | S100 calcium-binding protein B |
SIREN | Strategies to Innovate Emergency Care Clinical Trials Network |
SNCA | alpha-synuclein |
TBI | traumatic brain injury |
TQIP | Trauma Quality Improvement Program |
UHC-L1 | Ubiquitin C-terminal hydrolase L1 |
VA | Department of Veterans Affairs |