Despite changes in guideline-based management of moderate/severe traumatic brain injury
(TBI) over the preceding decades, little impact on mortality and morbidity have been
seen. This argues against the "one-treatment fits all" approach to such management
strategies. With this, some preliminary advances in the area of personalized medicine
in TBI care have displayed promising results. However, to continue transitioning toward
individually-tailored care, we require integration of complex "-omics" data sets.
The past few decades have seen dramatic increases in the volume of complex multi-modal
data in moderate and severe TBI care. Such data includes serial high-fidelity multi-modal
characterization of the cerebral physiome, serum/cerebrospinal fluid proteomics, admission
genetic profiles, and serial advanced neuroimaging modalities. Integrating these complex
and serially obtained data sets, with patient baseline demographics, treatment information
and clinical outcomes over time, can be a daunting task for the treating clinician.
Within this review, we highlight the current status of such multi-modal omics data
sets in moderate/severe TBI, current limitations to the utilization of such data,
and a potential path forward through employing integrative neuroinformatic approaches,
which are applied in other neuropathologies. Such advances are positioned to facilitate
the transition to precision prognostication and inform a top-down approach to the
development of personalized therapeutics in moderate/severe TBI.