@{MTMT:34823697, title = {Az agyi neurobiomarkerek diagnosztikus és prognosztikus értéke}, url = {https://m2.mtmt.hu/api/publication/34823697}, author = {Czeiter, Endre and Amrein, Krisztina}, booktitle = {Súlyos baleseti agysérültek ellátása}, unique-id = {34823697}, year = {2024}, pages = {63-66}, orcid-numbers = {Czeiter, Endre/0000-0002-9578-6944} } @{MTMT:34823375, title = {Az agysérülés neuroanatómiája}, url = {https://m2.mtmt.hu/api/publication/34823375}, author = {Czeiter, Endre and Fazekas, Bálint and Amrein, Krisztina}, booktitle = {Súlyos baleseti agysérültek ellátása}, unique-id = {34823375}, year = {2024}, pages = {33-46}, orcid-numbers = {Czeiter, Endre/0000-0002-9578-6944; Fazekas, Bálint/0000-0002-8445-4100} } @article{MTMT:34477399, title = {Screening Performance of S100B, GFAP and UCH-L1 For Intracranial Injury Within 6 hours of Injury and beyond}, url = {https://m2.mtmt.hu/api/publication/34477399}, author = {Trivedi, Dhanisha Trivedi and Forssten, Maximilian Peter and Cao, Yang and Mohammad Ismail, Ahmad and Czeiter, Endre and Amrein, Krisztina and Kobeissy, Firas and Wang, Kevin K W and DeSoucy, Erik and Büki, András and Mohseni, Shahin}, doi = {10.1089/neu.2023.0322}, journal-iso = {J NEUROTRAUM}, journal = {JOURNAL OF NEUROTRAUMA}, volume = {41}, unique-id = {34477399}, issn = {0897-7151}, abstract = {The Scandinavian NeuroTrauma Committee (SNC) guidelines recommend S100B as a screening tool for early detection of Traumatic brain injury (TBI) in patients presenting with an initial Glasgow coma scale (GCS) of 14-15. The objective of the current study was to compare S100B's diagnostic performance within the recommended 6-hour window after injury, compared to GFAP and UCH-L1. The secondary outcome of interest was the ability of these biomarkers in detecting traumatic intracranial pathology beyond the 6-hour mark.The Center-TBI core database (2014-2017) was queried for data pertaining to all TBI patients with an initial GCS of 14-15 who had a blood sample taken within 6 hours of injury in which the levels of S100B, GFAP, and UCH-L1 were measured. As a subgroup analysis, data involving patients with blood samples taken within 6-9 hours, and 9-12 hours were analyzed separately for diagnostic ability. The diagnostic ability of these biomarkers for detecting any intracranial injury was evaluated based on the area under the receiver operating characteristic curve (AUC). Each biomarker's sensitivity, specificity, and accuracy were also reported at the cutoff that maximized Youden's index.A total of 531 TBI patients with GCS 14-15 on admission had a blood sample taken within 6 hours, of whom 24.9% (N = 132) had radiologically confirmed intracranial injury. The AUCs of GFAP (0.86, 95% confidence interval (CI): 0.82-0.90) and UCH-L1 (0.81, 95% CI: 0.76-0.85) were statistically significantly higher than that of S100B (0.74, 95% CI: 0.69-0.79) during this time. There was no statistically significant difference in the predictive ability of S100B when sampled within 6 hours, 6-9 hours, and 9-12 hours of injury, as the p-values were >0.05 when comparing the AUCs. Overlapping AUC 95% CI suggests no benefit of a combined GFAP and UCH-L1 screening tool over GFAP during the time periods studied [ 0.87 (0.83-0.90) vs 0.86 (0.82-0.90) when sampled within 6 hours of injury, 0.83 (0.78-0.88) vs 0.83 (0.78-0.89) within 6-to-9 hours and 0.81 (0.73-0.88) vs 0.79 (0.72-0.87) within 9-12 hours].Targeted analysis of the CENTER-TBI core database, with focus on the patient category for which biomarker testing is recommended by the SNC guidelines, revealed that GFAP and UCH-L1 perform superior to S100B in predicting CT-positive intracranial lesions within 6 hours of injury. GFAP continued to exhibit superior predictive ability to S100B during the time periods studied. S100B displayed relatively unaltered screening performance beyond the diagnostic timeline provided by SNC guidelines. These findings suggest the need for a re-evaluation of the current SNC TBI guidelines.}, keywords = {Biomarkers; traumatic brain injury; Head trauma; adult brain injury}, year = {2024}, eissn = {1557-9042}, pages = {349-358}, orcid-numbers = {Czeiter, Endre/0000-0002-9578-6944} } @article{MTMT:34474356, title = {Blood biomarkers for traumatic brain injury: A narrative review of current evidence}, url = {https://m2.mtmt.hu/api/publication/34474356}, author = {Hossain, I. and Marklund, N. and Czeiter, Endre and Hutchinson, P. and Büki, András}, doi = {10.1016/j.bas.2023.102735}, journal-iso = {BRAIN SPINE}, journal = {BRAIN AND SPINE}, volume = {4}, unique-id = {34474356}, issn = {2772-5294}, year = {2024}, orcid-numbers = {Czeiter, Endre/0000-0002-9578-6944} } @article{MTMT:34392087, title = {Mild traumatic brain injury-induced persistent blood–brain barrier disruption is prevented by cyclosporine A treatment in hypertension}, url = {https://m2.mtmt.hu/api/publication/34392087}, author = {Lendvai-Emmert, Dominika and Magyar-Sümegi, Zsófia Dina and Hegedüs, Emőke and Szarka, Nikolett and Fazekas, Bálint and Amrein, Krisztina and Czeiter, Endre and Büki, András and Ungvári, Zoltán István and Tóth, Péter József}, doi = {10.3389/fneur.2023.1252796}, journal-iso = {FRONT NEUR}, journal = {FRONTIERS IN NEUROLOGY}, volume = {14}, unique-id = {34392087}, issn = {1664-2295}, year = {2023}, eissn = {1664-2295}, orcid-numbers = {Fazekas, Bálint/0000-0002-8445-4100; Czeiter, Endre/0000-0002-9578-6944; Ungvári, Zoltán István/0000-0002-6035-6039} } @article{MTMT:34050791, title = {Prognostic Value of Serum Biomarkers in Patients With Moderate-Severe Traumatic Brain Injury, Differentiated by Marshall Computer Tomography Classification}, url = {https://m2.mtmt.hu/api/publication/34050791}, author = {Richter, Sophie and Czeiter, Endre and Amrein, Krisztina and Mikolic, Ana and Verheyden, Jan and Wang, Kevin K and Maas, Andrew and Steyerberg, Ewout and Büki, András and Menon, David and Newcombe, Virginia}, doi = {10.1089/neu.2023.0029}, journal-iso = {J NEUROTRAUM}, journal = {JOURNAL OF NEUROTRAUMA}, volume = {40}, unique-id = {34050791}, issn = {0897-7151}, abstract = {Prognostication is challenging in traumatic brain injury (TBI) patients in whom the CT fails to fully explain a low level of consciousness. Serum biomarkers reflect the extent of structural damage in a different way than CT does, but it is unclear if biomarkers provide additional prognostic value across the range of CT abnormalities. This study aimed to determine the added predictive value of biomarkers, differentiated by imaging severity. This prognostic study used data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study (2014-2017). The analysis included patients aged ≥16 years with a moderate-severe TBI (Glasgow Coma Scale, GCS < 13) who had an acute CT and serum biomarkers obtained ≤24h of injury. Out of six protein biomarkers (GFAP, NFL, NSE, S100B, Tau, UCH-L1) the most prognostic panel was selected using lasso regression. The performance of established prognostic models (CRASH and IMPACT) was assessed before and after the addition of the biomarker panel, and compared between patients with different CT Marshall scores (Marshall score <3 versus Marshall score ≥3). Outcome was assessed at 6 months post-injury using the extended Glasgow Outcome Scale (GOSE), and dichotomized into favorable and unfavourable (GOSE <5). We included 872 patients with moderate-severe TBI. The mean age was 47 years (range 16 - 95), 647 (74%) were male and 438 (50%) had a Marshall CT score <3. The serum biomarkers GFAP, NFL, S100B and UCH-L1 provided complementary prognostic information, NSE and Tau showed no added value. The addition of the biomarker panel to established prognostic models increased the area under the curve (AUC) by 0.08 and 0.03, and the explained variation in outcome by 13-14% and 7-8%, for patients with a Marshall score of <3 and ≥3, respectively. The incremental AUC of biomarkers for individual models was significantly greater when the Marshall score was <3 compared to ≥3 (p < 0.001). Serum biomarkers improve outcome prediction after moderate-severe TBI across the range of imaging severities and especially in patients with a Marshall score <3.}, keywords = {Biomarkers; prospective study; traumatic brain injury; adult brain injury; CT scanning}, year = {2023}, eissn = {1557-9042}, pages = {2297-2310}, orcid-numbers = {Czeiter, Endre/0000-0002-9578-6944} } @article{MTMT:34021464, title = {The lower limit of reactivity as a potential individualised cerebral perfusion pressure target in traumatic brain injury : a CENTER-TBI high-resolution sub-study analysis}, url = {https://m2.mtmt.hu/api/publication/34021464}, author = {Beqiri, Erta and Zeiler, Frederick A and Ercole, Ari and Placek, Michal M and Tas, Jeanette and Donnelly, Joseph and Aries, Marcel J H and Hutchinson, Peter J and Menon, David and Stocchetti, Nino and Czosnyka, Marek and Smielewski, Peter}, doi = {10.1186/s13054-023-04485-8}, journal-iso = {CRIT CARE}, journal = {CRITICAL CARE}, volume = {27}, unique-id = {34021464}, issn = {1364-8535}, abstract = {A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort.Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal-Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong's test.Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP < LLR could predict mortality (AUC 0.73, p = < 0.001). This association becomes significant starting from the third day post injury. The relationship was maintained when correcting for IMPACT covariates or for high ICP.Using a multicentre cohort, we confirmed that CPP below LLR was associated with mortality during the first seven days post injury.}, keywords = {traumatic brain injury; Cerebral autoregulation; Lower limit of reactivity; Individualised cerebral perfusion pressure}, year = {2023}, eissn = {1466-609X}, orcid-numbers = {Czeiter, Endre/0000-0002-9578-6944} } @article{MTMT:33718370, title = {Accuracy of Manual Intracranial Pressure Recording Compared to a Computerized High-Resolution System : A CENTER-TBI Analysis}, url = {https://m2.mtmt.hu/api/publication/33718370}, author = {Zoerle, Tommaso and Birg, Tatiana and Carbonara, Marco and Smielewski, Peter and Placek, Michal M and Zanier, Elisa R and Åkerlund, Cecilia A I and Ortolano, Fabrizio and Stocchetti, Nino}, doi = {10.1007/s12028-023-01697-2}, journal-iso = {NEUROCRIT CARE}, journal = {NEUROCRITICAL CARE}, volume = {38}, unique-id = {33718370}, issn = {1541-6933}, abstract = {Monitoring intracranial pressure (ICP) and cerebral perfusion pressure (CPP) is crucial in the management of the patient with severe traumatic brain injury (TBI). In several institutions ICP and CPP are summarized hourly and entered manually on bedside charts; these data have been used in large observational and interventional trials. However, ICP and CPP may change rapidly and frequently, so data recorded in medical charts might underestimate actual ICP and CPP shifts. The aim of this study was to evaluate the accuracy of manual data annotation for proper capturing of ICP and CPP. For this aim, we (1) compared end-hour ICP and CPP values manually recorded (MR) with values recorded continuously by computerized high-resolution (HR) systems and (2) analyzed whether MR ICP and MR CPP are reliable indicators of the burden of intracranial hypertension and low CPP.One hundred patients were included. First, we compared the MR data with the values stored in the computerized system during the first 7 days after admission. For this point-to-point analysis, we calculated the difference between end-hour MR and HR ICP and CPP. Then we analyzed the burden of high ICP (> 20 mm Hg) and low CPP (< 60 mm Hg) measured by the computerized system, in which continuous data were stored, compared with the pressure-time dose based on end-hour measurements.The mean difference between MR and HR end-hour values was 0.02 mm Hg for ICP (SD 3.86 mm Hg) and 1.54 mm Hg for CPP (SD 8.81 mm Hg). ICP > 20 mm Hg and CPP < 60 mm Hg were not detected by MR in 1.6% and 5.8% of synchronized measurements, respectively. Analysis of the pathological ICP and CPP throughout the recording, however, indicated that calculations based on manual recording seriously underestimated the ICP and CPP burden (in 42% and 28% of patients, respectively).Manual entries fairly represent end-hour HR ICP and CPP. However, compared with a computerized system, they may prove inadequate, with a serious risk of underestimation of the ICP and CPP burden.}, keywords = {Data Collection; traumatic brain injury; Intracranial Pressure; cerebral perfusion pressure}, year = {2023}, eissn = {1556-0961}, pages = {781-790}, orcid-numbers = {Czeiter, Endre/0000-0002-9578-6944} } @CONFERENCE{MTMT:33704639, title = {Alleviation of longterm cognitive impairment with memantine combined with alfa7 nicotic receptor ligand after repetitive mild traumatic brain injury in rats}, url = {https://m2.mtmt.hu/api/publication/33704639}, author = {Kolozsvári, Áron and Bali, Zsolt Kristóf and Bruszt, Nóra and Nagy, Lili Veronika and Fazekas, Bálint and Amrein, Krisztina and Czeiter, Endre and Büki, András and Hernádi, István}, booktitle = {Joint Neuroscience Meeting of the Hungarian Neuroscience Society (MITT) & the Austrian Neuroscience Association (ANA)}, unique-id = {33704639}, year = {2023}, pages = {136}, orcid-numbers = {Bali, Zsolt Kristóf/0000-0003-0712-0788; Fazekas, Bálint/0000-0002-8445-4100; Czeiter, Endre/0000-0002-9578-6944; Hernádi, István/0000-0001-7882-4817} } @article{MTMT:33695777, title = {Traumatic Brain Injury Induces Microglial and Caspase3 Activation in the Retina}, url = {https://m2.mtmt.hu/api/publication/33695777}, author = {Kovács-Öller, Tamás and Zempléni, Renáta and Balogh, Boglárka and Szarka, Gergely and Fazekas, Bálint and Tengölics, Ádám Jonatán and Amrein, Krisztina and Czeiter, Endre and Hernádi, István and Büki, András and Völgyi, Béla}, doi = {10.3390/ijms24054451}, journal-iso = {INT J MOL SCI}, journal = {INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES}, volume = {24}, unique-id = {33695777}, issn = {1661-6596}, abstract = {Traumatic brain injury (TBI) is among the main causes of sudden death after head trauma. These injuries can result in severe degeneration and neuronal cell death in the CNS, including the retina, which is a crucial part of the brain responsible for perceiving and transmitting visual information. The long-term effects of mild-repetitive TBI (rmTBI) are far less studied thus far, even though damage induced by repetitive injuries occurring in the brain is more common, especially amongst athletes. rmTBI can also have a detrimental effect on the retina and the pathophysiology of these injuries is likely to differ from severe TBI (sTBI) retinal injury. Here, we show how rmTBI and sTBI can differentially affect the retina. Our results indicate an increase in the number of activated microglial cells and Caspase3-positive cells in the retina in both traumatic models, suggesting a rise in the level of inflammation and cell death after TBI. The pattern of microglial activation appears distributed and widespread but differs amongst the various retinal layers. sTBI induced microglial activation in both the superficial and deep retinal layers. In contrast to sTBI, no significant change occurred following the repetitive mild injury in the superficial layer, only the deep layer (spanning from the inner nuclear layer to the outer plexiform layer) shows microglial activation. This difference suggests that alternate response mechanisms play a role in the case of the different TBI incidents. The Caspase3 activation pattern showed a uniform increase in both the superficial and deep layers of the retina. This suggests a different action in the course of the disease in sTBI and rmTBI models and points to the need for new diagnostic procedures. Our present results suggest that the retina might serve as such a model of head injuries since the retinal tissue reacts to both forms of TBI and is the most accessible part of the human brain.}, keywords = {Brain; APOPTOSIS; INJURY; DEGENERATION; microglia; Retina; caspase; TBI}, year = {2023}, eissn = {1422-0067}, orcid-numbers = {Kovács-Öller, Tamás/0000-0002-3353-4485; Balogh, Boglárka/0000-0002-4022-8953; Fazekas, Bálint/0000-0002-8445-4100; Czeiter, Endre/0000-0002-9578-6944; Hernádi, István/0000-0001-7882-4817; Völgyi, Béla/0000-0001-7481-390X} }