E-Pearl of the Week: Biomarkers in Traumatic Brain Injury

May 9, 2012


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Brought to you by the Resident and Fellow Section of Neurology®.

May 1, 2012

Biomarkers in Traumatic Brain Injury

Several brain–derived biomarkers may be increased in the serum of patients with traumatic brain injury (TBI). These include S–100B, an astroglial protein, and glial fibrillary acidic protein (GFAP), an intermediate–filament component of the astrocytic cytoskeleton. In patients with moderate to severe TBI who have poor outcomes, serum levels of GFAP have been found to be increased nearly 20–fold, and S100B increased 2–fold, when compared to TBI patients with favorable outcomes. Thus, when used as an adjuvant to clinical variables such as pupillary reflexes and age, serum levels of GFAP and S10OB may enhance prognostication in patients with moderate–severe TBI. These markers, however, may not be as useful in individual patients with mild TBI.


1. Vos PE, Jacobs B, Andriessen TM, et al. GFAP and S100B are biomarkers of traumatic brain injury: an observational cohort study. Neurology. 2010; 75: 1786–1793.
2. Metting Z, Wilczak N, Rodiger LA, Schaaf JM, van der Naalt J. GFAP and S100B in the acute phase of mild traumatic brain injury. Neurology. 2012; 78: 1428–1433.

Submitted by: Jennifer E. Fugate, DO

Disclosure: Dr. Fugate serves on the editorial team for the Neurology Resident and Fellow Section.

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