Eric Mercier1,2,3,4, Pier-Alexandre Tardif2, Peter A Cameron3,4,5, Marcel Émond1,2,6, Lynne Moore2,7, Biswadev Mitra3,4,5, Marie-Christine Ouellet2,8, Jérôme Frenette8, Elaine de Guise9,10, Natalie Le Sage1,2. 1. a Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , Canada. 2. b Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada. 3. c Emergency and Trauma Centre , The Alfred Hospital, Alfred Health , Melbourne , Australia. 4. d School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia. 5. e National Trauma Research Institute , The Alfred Hospital , Melbourne , VIC , Australia. 6. f Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Vieillissement, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada. 7. g Département de Médecine Sociale et Préventive, Faculté de Médecine , Université Laval , Québec , Canada. 8. h Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS) , Québec , Québec , Canada. 9. i Research-Institute , McGill University Health Centre , Montreal , Québec , Canada. 10. j Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montréal , Québec , Canada.
Abstract
BACKGROUND: This systematic review aimed to determine the prognostic value of neuron-specific enolase (NSE) to predict post-concussion symptoms following mild traumatic brain injury (TBI). METHODS: Seven databases were searched for studies evaluating the association between NSE levels and post-concussion symptoms assessed ≥ 3 months (persistent) or ≥ 7 days < 3 months (early) after mild TBI. Two researchers independently screened studies for inclusion, extracted data and appraised quality using the Quality in Prognostic Studies (QUIPS) tool. RESULTS: The search strategy yielded a total of 23,298 citations from which 8 cohorts presented in 10 studies were included. Studies included between 45 and 141 patients (total 608 patients). The outcomes most frequently assessed were post-concussion syndrome (PCS, 12 assessments) and neuropsychological performance deficits (10 assessments). No association was found between an elevated NSE serum level and PCS. Only one study reported a statistically significant association between a higher NSE serum level and alteration of at least three cognitive domains at 2 weeks but this association was no longer significant at 6 weeks. Overall, risk of bias of the included studies was considered moderate. CONCLUSIONS: Early NSE serum level is not a strong independent predictor of post-concussion symptoms following mild TBI.
BACKGROUND: This systematic review aimed to determine the prognostic value of neuron-specific enolase (NSE) to predict post-concussion symptoms following mild traumatic brain injury (TBI). METHODS: Seven databases were searched for studies evaluating the association between NSE levels and post-concussion symptoms assessed ≥ 3 months (persistent) or ≥ 7 days < 3 months (early) after mild TBI. Two researchers independently screened studies for inclusion, extracted data and appraised quality using the Quality in Prognostic Studies (QUIPS) tool. RESULTS: The search strategy yielded a total of 23,298 citations from which 8 cohorts presented in 10 studies were included. Studies included between 45 and 141 patients (total 608 patients). The outcomes most frequently assessed were post-concussion syndrome (PCS, 12 assessments) and neuropsychological performance deficits (10 assessments). No association was found between an elevated NSE serum level and PCS. Only one study reported a statistically significant association between a higher NSE serum level and alteration of at least three cognitive domains at 2 weeks but this association was no longer significant at 6 weeks. Overall, risk of bias of the included studies was considered moderate. CONCLUSIONS: Early NSE serum level is not a strong independent predictor of post-concussion symptoms following mild TBI.
Authors: Aleksandra Gozt; Melissa Licari; Alison Halstrom; Hannah Milbourn; Stephen Lydiard; Anna Black; Glenn Arendts; Stephen Macdonald; Swithin Song; Ellen MacDonald; Philip Vlaskovsky; Sally Burrows; Michael Bynevelt; Carmela Pestell; Daniel Fatovich; Melinda Fitzgerald Journal: Brain Sci Date: 2020-01-02