Investigating The Diagnostic Utility Of Serum Brain-derived Neurotrophic Factor (bdnf) For Young Children With Acute Traumatic Brain Injuries
*Tara Rhine, Lily Yu
CCHMC, Cincinnati, OH
Background: Diagnosis of traumatic brain injury (TBI) is challenging in young children, as symptoms are often vague (e.g., fussiness) and the injury mechanism may be unknown. Brain-derived Neurotrophic Factor (BDNF) is a serum biomarker that has demonstrated diagnostic utility for adult TBI. Our objective was to evaluate if BDNF levels were significantly different between young children with TBI and non-injured (NI) children.
Methods: Sub-analysis of a prospective cohort study that enrolled children, ages 0-4 years, from a single pediatric medical center. TBI patients were recruited from the emergency department if they had acute injury on head CT. Children obtaining routine blood work at the primary care clinic were recruited for the NI group. Nonparametric and area under the receiver operating characteristics curve (AUC) analyses were employed.
Results: We analyzed data for 42 TBI and 30 NI children. Median (interquartile range (IQR)) BDNF levels (ng/mL) were significantly higher in TBI compared to NI: 19.6 (10.0-31.7) versus 15.0 (10.1-18.8), respectively (p=0.04). BDNF discriminated TBI from NI with an AUC of 0.65 (95% CI: 0.52-0.75). Ten patients were later identified as having abusive TBI, and we found much lower BDNF levels in this group (15.1) as compared to children with accidental TBI (21.1). BDNF discriminated children with accidental TBI from NI with an AUC of 0.67 (95% CI: 0.55-0.79).
Conclusion: Serum BDNF values were significantly higher among young children acutely following TBI, as compared to NI children. However, BDNF may be a more sensitive marker for accidental versus abusive TBI.
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