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Saliva RNA biomarkers predict concussion duration and detect symptom recovery: a comparison with balance and cognitive testing.
Fedorchak, Gregory; Rangnekar, Aakanksha; Onks, Cayce; Loeffert, Andrea C; Loeffert, Jayson; Olympia, Robert P; DeVita, Samantha; Leddy, John; Haider, Mohammad N; Roberts, Aaron; Rieger, Jessica; Uhlig, Thomas; Monteith, Chuck; Middleton, Frank; Zuckerman, Scott L; Lee, Timothy; Yeates, Keith Owen; Mannix, Rebekah; Hicks, Steven.
Afiliación
  • Fedorchak G; Quadrant Biosciences, Syracuse, NY, 13210, USA.
  • Rangnekar A; Quadrant Biosciences, Syracuse, NY, 13210, USA.
  • Onks C; Department of Family Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA.
  • Loeffert AC; Department of Pediatrics, Penn State College of Medicine, Hershey, PA, 17033, USA.
  • Loeffert J; Department of Family Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA.
  • Olympia RP; Department of Emergency Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA.
  • DeVita S; Quadrant Biosciences, Syracuse, NY, 13210, USA.
  • Leddy J; SUNY Buffalo Jacobs School of Medicine and Biomedical Sciences, UBMD Orthopaedics and Sports Medicine, Buffalo, NY, 14214, USA.
  • Haider MN; SUNY Buffalo Jacobs School of Medicine and Biomedical Sciences, UBMD Orthopaedics and Sports Medicine, Buffalo, NY, 14214, USA.
  • Roberts A; Department of Adena Regional Medical Center, Adena Bone and Joint Center, Chillicothe, OH, 45601, USA.
  • Rieger J; Quadrant Biosciences, Syracuse, NY, 13210, USA.
  • Uhlig T; Quadrant Biosciences, Syracuse, NY, 13210, USA.
  • Monteith C; Colgate University, Hamilton, NY, 13346, USA.
  • Middleton F; Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA.
  • Zuckerman SL; Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN, 37212, USA.
  • Lee T; Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN, 37212, USA.
  • Yeates KO; Department of Psychology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada.
  • Mannix R; Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
  • Hicks S; Department of Pediatrics, Penn State College of Medicine, Hershey, PA, 17033, USA. shicks1@pennstatehealth.psu.edu.
J Neurol ; 268(11): 4349-4361, 2021 Nov.
Article en En | MEDLINE | ID: mdl-34028616
OBJECTIVE: The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance. METHODS: RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8-24-years-old) with mild traumatic brain injury (mTBI). Initial samples were obtained ≤ 14 days post-injury, and follow-up samples were obtained ≥ 21 days post-injury. Computerized balance and cognitive test performance were assessed at initial and follow-up time-points. Machine learning was used to define: (1) a model employing initial ncRNA levels to predict persistent post-concussion symptoms (PPCS) ≥ 21 days post-injury; and (2) a model employing follow-up ncRNA levels to identify symptom recovery. Performance of the models was compared against a validated clinical prediction rule, and balance/cognitive test performance, respectively. RESULTS: An algorithm using age and 16 ncRNAs predicted PPCS with greater accuracy than the validated clinical tool and demonstrated additive combined utility (area under the curve (AUC) 0.86; 95% CI 0.84-0.88). Initial balance and cognitive test performance did not differ between PPCS and non-PPCS groups (p > 0.05). Follow-up balance and cognitive test performance identified symptom recovery with similar accuracy to a model using 11 ncRNAs and age. A combined model (ncRNAs, balance, cognition) most accurately identified recovery (AUC 0.86; 95% CI 0.83-0.89). CONCLUSIONS: ncRNA biomarkers show promise for tracking recovery from mTBI, and for predicting who will have prolonged symptoms. They could provide accurate expectations for recovery, stratify need for intervention, and guide safe return-to-activities.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conmoción Encefálica Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Humans Idioma: En Revista: J Neurol Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conmoción Encefálica Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Humans Idioma: En Revista: J Neurol Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania