Neurology Medical News about S-100B, NSE, Intracranial pressure

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S-100B and NSE are poor outcome predictors in severe traumatic brain injury treated by an ICP targeted therapy
Journal of Neurology, Neurosurgery, and Psychiatry , 07/22/09

Olivecrona M et al. – Study failed to show any difference of prognostic values between the markers (S-100B and NSE levels) at 3 and 12 months after trauma, neither any clinical significant value of the markers as predictors of clinical outcome.

Methods

Main objectives of this study were to investigate:
- S-100B and NSE levels, in subjects treated for severe head injury (sTBI), and
- Prognostic value of these biomarkers
Inclusion criteria for subjects:
- Glasgow Coma Score (GCS) ≤8
- Age 15 – 70 years
- First recorded cerebral perfusion pressure of > 10 mmHg, and
- Arrival < 24 hours after trauma
Subjects were treated with an intracranial pressure (ICP) targeted therapy
Blood samples for S-100B and NSE were drawn immediately after arrival and every 12 hour for 5 days
Outcome was evaluated as Glasgow Outcome Scale (GOS) by independent staff at 3 and 12 mo

Results

48 subjects; mean age 35.5 yrs; median GCS 6 were included
First blood sample was drawn at 15.6 ± 1.4 hrs after injury
Initial concentration of S-100B was 1.04 ± 0.21 µg/l and for NSE 18.94 ± 2.32 µg/l
Biomarkers were higher in subjects with those included as GCS 3 and in those who died vs GCS 4-8 and GOS 2-5, respectively
ROC curve analyses of the initial S-100B and NSE levels to GOS dichotomised as unfavourable (GOS 1-3) and favourable (GOS 4-5) showed a weak correlation
Using the dichotomisation dead (GOS 1) / alive (GOS 2-5), the AUC was 0.687 and 0.734 respectively
Further, a correlation was found between the biomarkers themselves and the biomarkers and ICP

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