TY - JOUR AU - Trivedi, Dhanisha Trivedi AU - Forssten, Maximilian Peter AU - Cao, Yang AU - Mohammad Ismail, Ahmad AU - Czeiter, Endre AU - Amrein, Krisztina AU - Kobeissy, Firas AU - Wang, Kevin K W AU - DeSoucy, Erik AU - Büki, András AU - Mohseni, Shahin TI - Screening Performance of S100B, GFAP and UCH-L1 For Intracranial Injury Within 6 hours of Injury and beyond JF - JOURNAL OF NEUROTRAUMA J2 - J NEUROTRAUM VL - 41 PY - 2024 IS - 3-4 SP - 349 EP - 358 PG - 10 SN - 0897-7151 DO - 10.1089/neu.2023.0322 UR - https://m2.mtmt.hu/api/publication/34477399 ID - 34477399 N1 - * Megosztott szerzőség AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Hossain, I. AU - Marklund, N. AU - Czeiter, Endre AU - Hutchinson, P. AU - Büki, András TI - Blood biomarkers for traumatic brain injury: A narrative review of current evidence JF - BRAIN AND SPINE J2 - BRAIN SPINE VL - 4 PY - 2024 PG - 9 SN - 2772-5294 DO - 10.1016/j.bas.2023.102735 UR - https://m2.mtmt.hu/api/publication/34474356 ID - 34474356 N1 - * Megosztott szerzőség LA - English DB - MTMT ER - TY - JOUR AU - Lendvai-Emmert, Dominika AU - Magyar-Sümegi, Zsófia Dina AU - Hegedüs, Emőke AU - Szarka, Nikolett AU - Fazekas, Bálint AU - Amrein, Krisztina AU - Czeiter, Endre AU - Büki, András AU - Ungvári, Zoltán István AU - Tóth, Péter József TI - Mild traumatic brain injury-induced persistent blood–brain barrier disruption is prevented by cyclosporine A treatment in hypertension JF - FRONTIERS IN NEUROLOGY J2 - FRONT NEUR VL - 14 PY - 2023 PG - 9 SN - 1664-2295 DO - 10.3389/fneur.2023.1252796 UR - https://m2.mtmt.hu/api/publication/34392087 ID - 34392087 N1 - This work was supported by grants from the National Research, Development and Innovation Office (OTKA K-134555 and OTKA FK-123798 to PT), the Hungarian Academy of Sciences Bolyai Research Scholarship (to PT), National Clinical Neuroscience Laboratory (RRF-2.3.1-21-2022-00011), the Thematic Excellence Program 2021 Health sub-program of the Ministry for Innovation and Technology in Hungary, within the framework of the EGA-16 project of the University of Pecs (to PT), the National Institute on Aging (RF1AG072295, R01AG055395, R01AG068295, and K01-AG073614), the National Institute of Neurological Disorders and Stroke (R01NS100782), the National Cancer Institute (R01CA255840). LA - English DB - MTMT ER - TY - JOUR AU - Richter, Sophie AU - Czeiter, Endre AU - Amrein, Krisztina AU - Mikolic, Ana AU - Verheyden, Jan AU - Wang, Kevin K AU - Maas, Andrew AU - Steyerberg, Ewout AU - Büki, András AU - Menon, David AU - Newcombe, Virginia TI - Prognostic Value of Serum Biomarkers in Patients With Moderate-Severe Traumatic Brain Injury, Differentiated by Marshall Computer Tomography Classification JF - JOURNAL OF NEUROTRAUMA J2 - J NEUROTRAUM VL - 40 PY - 2023 IS - 21-22 SP - 2297 EP - 2310 PG - 14 SN - 0897-7151 DO - 10.1089/neu.2023.0029 UR - https://m2.mtmt.hu/api/publication/34050791 ID - 34050791 N1 - University Division of Anaesthesia, University of Cambridge, Cambridge, United Kingdom Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary Neurotrauma Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary ELKH-PTE Clinical Neuroscience MR Research Group, University of Pécs, Pécs, Hungary Department of Psychology, University of British Columbia, Vancouver, BC, Canada Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, BC, Canada Research and Development, icometrix, Leuven, Belgium Program for Neurotrauma, Neuroproteomics and Biomarker Research, Departments of Emergency Medicine, Psychiatry and Neuroscience, University of Florida, Gainesville, FL, United States Department of Neurosurgery, Antwerp University Hospital, University of Antwerp, Edegem, Belgium Department of Biomedical Data Sciences, University Medical Centre, Leiden, Netherlands Örebro University, School of Medical Sciences, Örebro, Sweden Export Date: 1 February 2024 CODEN: JNEUE Correspondence Address: Richter, S.; University Division of Anaesthesia, Box 93, Hills Road, United Kingdom; email: sr773@cam.ac.uk Correspondence Address: Newcombe, V.F.J.; University Division of Anaesthesia, Box 93, Hills Road, United Kingdom; email: vfjn2@cam.ac.uk AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Beqiri, Erta AU - Zeiler, Frederick A AU - Ercole, Ari AU - Placek, Michal M AU - Tas, Jeanette AU - Donnelly, Joseph AU - Aries, Marcel J H AU - Hutchinson, Peter J AU - Menon, David AU - Stocchetti, Nino AU - Czosnyka, Marek AU - Smielewski, Peter ED - Anke, Audny / Collaborator ED - Beer, Ronny / Collaborator ED - Bellander, Bo-Michael / Collaborator ED - Büki, András / Collaborator ED - Cabeleira, Manuel / Collaborator ED - Carbonara, Marco / Collaborator ED - Chieregato, Arturo / Collaborator ED - Citerio, Giuseppe / Collaborator ED - Clusmann, Hans / Collaborator ED - Czeiter, Endre / Collaborator ED - Depreitere, Bart / Collaborator ED - Frisvold, Shirin / Collaborator ED - Helbok, Raimund / Collaborator ED - Jankowski, Stefan / Collaborator ED - Kondziella, Daniel / Collaborator ED - Koskinen, Lars-Owe / Collaborator ED - Kowark, Ana / Collaborator ED - Meyfroidt, Geert / Collaborator ED - Moeller, Kirsten / Collaborator ED - Nelson, David / Collaborator ED - Piippo-Karjalainen, Anna / Collaborator ED - Radoi, Andreea / Collaborator ED - Ragauskas, Arminas / Collaborator ED - Raj, Rahul / Collaborator ED - Rhodes, Jonathan / Collaborator ED - Rocka, Saulius / Collaborator ED - Rossaint, Rolf / Collaborator ED - Sahuquillo, Juan / Collaborator ED - Sakowitz, Oliver / Collaborator ED - Sundström, Nina / Collaborator ED - Takala, Riikka / Collaborator ED - Tamosuitis, Tomas / Collaborator ED - Tenovuo, Olli / Collaborator ED - Unterberg, Andreas / Collaborator ED - Vajkoczy, Peter / Collaborator ED - Vargiolu, Alessia / Collaborator ED - Vilcinis, Rimantas / Collaborator ED - Wolf, Stefan / Collaborator ED - Younsi, Alexander / Collaborator TI - 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 JF - CRITICAL CARE J2 - CRIT CARE VL - 27 PY - 2023 IS - 1 PG - 14 SN - 1364-8535 DO - 10.1186/s13054-023-04485-8 UR - https://m2.mtmt.hu/api/publication/34021464 ID - 34021464 N1 - Funding Agency and Grant Number: European Union 7th Framework program (EC Grant) [602150]; Hannelore Kohl Stiftung (Germany); OneMind (USA); Integra LifeSciences Corporation (USA); CTBI scholarship (EC Grant) [602150]; Medical Research Council [MR N013433-1]; Gates Cambridge Scholarship; Natural Sciences and Engineering Research Council of Canada (NSERC) [DGECR-202200260, RGPIN-202203621, ALLRP-57638622]; Canadian Institutes of Health Research (CIHR); MPI Neuroscience Research Operating Fund; Health Sciences Centre Foundation Winnipeg; Canada Foundation for Innovation (CFI) [38583]; Research Manitoba [3906]; University of Manitoba MPI Professorship in Neuroscience; Brain Battle' Foundation (HersenStrijd fonds) from the University Maastricht,The Netherlands; Neurological Foundation of New Zealand; European Union seventh Framework Program [602150]; Action Medical Research [GN2609]; National Institute for Health Research (NIHR), Cambridge Biomedical Research Centre Funding text: Data used in preparation of this manuscript were obtained in the context of CENTER-TBI, a large collaborative project with the support of the European Union 7th Framework program (EC Grant 602150). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), from OneMind (USA) and from Integra LifeSciences Corporation (USA). For the writing of this manuscript Erta Beqiri was supported by CTBI scholarship (EC Grant no:602150) and is currently supported by the Medical Research Council (Grant no.: MR N013433-1) and by the Gates Cambridge Scholarship. FAZ receives research support from the Natural Sciences and Engineering Research Council of Canada (NSERC)(DGECR-2022-00260, RGPIN-2022-03621 and ALLRP-576386-22), Canadian Institutes of Health Research (CIHR), the MPI Neuroscience Research Operating Fund, the Health Sciences Centre Foundation Winnipeg, the Canada Foundation for Innovation (CFI) (Project #: 38583), Research Manitoba (Grant #: 3906), and the University of Manitoba MPI Professorship in Neuroscience. MJH Aries and J Tas are supported by a grant from the Brain Battle' Foundation (HersenStrijd fonds) from the University Maastricht,The Netherlands. Joseph Donnelly is supported by the Neurological Foundation of New Zealand. M. M. Placek was supported by the European Union seventh Framework Program (Grant 602150) for Collaborative European NeuroTrauma Effectiveness Research inTraumatic Brain Injury (CENTER-TBI) until March 2021 and by Action Medical Research (Grant GN2609) for Studying Trends of Auto-Regulation in Severe Head Injury in Paediatrics (STARSHIP) until December 2021. Marek Czosnyka is supported by National Institute for Health Research (NIHR), Cambridge Biomedical Research Centre. AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Zoerle, Tommaso AU - Birg, Tatiana AU - Carbonara, Marco AU - Smielewski, Peter AU - Placek, Michal M AU - Zanier, Elisa R AU - Åkerlund, Cecilia A I AU - Ortolano, Fabrizio AU - Stocchetti, Nino ED - Anke, Audny / Collaborator ED - Beer, Ronny / Collaborator ED - Bellander, Bo-Michael / Collaborator ED - Beqiri, Erta / Collaborator ED - Büki, András / Collaborator ED - Cabeleira, Manuel / Collaborator ED - Chieregato, Arturo / Collaborator ED - Citerio, Giuseppe / Collaborator ED - Clusmann, Hans / Collaborator ED - Czeiter, Endre / Collaborator ED - Czosnyka, Marek / Collaborator ED - Depreitere, Bart / Collaborator ED - Ercole, Ari / Collaborator ED - Frisvold, Shirin / Collaborator ED - Helbok, Raimund / Collaborator ED - Jankowski, Stefan / Collaborator ED - Kondziella, Daniel / Collaborator ED - Koskinen, Lars-Owe / Collaborator ED - Kowark, Ana / Collaborator ED - Menon, David K / Collaborator ED - Meyfroidt, Geert / Collaborator ED - Moeller, Kirsten / Collaborator ED - Nelson, David / Collaborator ED - Piippo-Karjalainen, Anna / Collaborator ED - Radoi, Andreea / Collaborator ED - Ragauskas, Arminas / Collaborator ED - Raj, Rahul / Collaborator ED - Rhodes, Jonathan / Collaborator ED - Rocka, Saulius / Collaborator ED - Rossaint, Rolf / Collaborator ED - Sahuquillo, Juan / Collaborator ED - Sakowitz, Oliver / Collaborator ED - Smielewski, Peter / Collaborator ED - Sundström, Nina / Collaborator ED - Takala, Riikka / Collaborator ED - Tamosuitis, Tomas / Collaborator ED - Tenovuo, Olli / Collaborator ED - Unterberg, Andreas / Collaborator ED - Vajkoczy, Peter / Collaborator ED - Vargiolu, Alessia / Collaborator ED - Vilcinis, Rimantas / Collaborator ED - Wolf, Stefan / Collaborator ED - Younsi, Alexander / Collaborator ED - Zeiler, Frederick A / Collaborator TI - Accuracy of Manual Intracranial Pressure Recording Compared to a Computerized High-Resolution System : A CENTER-TBI Analysis JF - NEUROCRITICAL CARE J2 - NEUROCRIT CARE VL - 38 PY - 2023 IS - 3 SP - 781 EP - 790 PG - 10 SN - 1541-6933 DO - 10.1007/s12028-023-01697-2 UR - https://m2.mtmt.hu/api/publication/33718370 ID - 33718370 AB - 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. LA - English DB - MTMT ER - TY - CONF AU - Kolozsvári, Áron AU - Bali, Zsolt Kristóf AU - Bruszt, Nóra AU - Nagy, Lili Veronika AU - Fazekas, Bálint AU - Amrein, Krisztina AU - Czeiter, Endre AU - Büki, András AU - Hernádi, István TI - Alleviation of longterm cognitive impairment with memantine combined with alfa7 nicotic receptor ligand after repetitive mild traumatic brain injury in rats T2 - Joint Neuroscience Meeting of the Hungarian Neuroscience Society (MITT) & the Austrian Neuroscience Association (ANA) PY - 2023 SP - 136 UR - https://m2.mtmt.hu/api/publication/33704639 ID - 33704639 LA - English DB - MTMT ER - TY - JOUR AU - Kovács-Öller, Tamás AU - Zempléni, Renáta AU - Balogh, Boglárka AU - Szarka, Gergely AU - Fazekas, Bálint AU - Tengölics, Ádám Jonatán AU - Amrein, Krisztina AU - Czeiter, Endre AU - Hernádi, István AU - Büki, András AU - Völgyi, Béla TI - Traumatic Brain Injury Induces Microglial and Caspase3 Activation in the Retina JF - INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES J2 - INT J MOL SCI VL - 24 PY - 2023 IS - 5 PG - 16 SN - 1661-6596 DO - 10.3390/ijms24054451 UR - https://m2.mtmt.hu/api/publication/33695777 ID - 33695777 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Richter, S. AU - Winzeck, S. AU - Czeiter, Endre AU - Amrein, Krisztina AU - Kornaropoulos, E.N. AU - Verheyden, J. AU - Sugar, G. AU - Yang, Z. AU - Wang, K. AU - Maas, A.I.R. AU - Steyerberg, E. AU - Büki, András AU - Newcombe, V.F.J. AU - Menon, D.K. TI - Serum biomarkers identify critically ill traumatic brain injury patients for MRI JF - CRITICAL CARE J2 - CRIT CARE VL - 26 PY - 2022 IS - 1 PG - 7 SN - 1364-8535 DO - 10.1186/s13054-022-04250-3 UR - https://m2.mtmt.hu/api/publication/33339230 ID - 33339230 N1 - Brief report CN: Collaborative European NeuroTrauma Efectiveness Research in Traumatic Brain Injury Magnetic Resonance Imaging (CENTER-TBI MRI) Sub-study Participants and Investigators LA - English DB - MTMT ER - TY - JOUR AU - Dimitri, Giovanna Maria AU - Beqiri, Erta AU - Placek, Michal M AU - Czosnyka, Marek AU - Stocchetti, Nino AU - Ercole, Ari AU - Smielewski, Peter AU - Lió, Pietro ED - Anke, Audny / Collaborator ED - Beer, Ronny / Collaborator ED - Bellander, Bo-Michael / Collaborator ED - Beqiri, Erta / Collaborator ED - Büki, András / Collaborator ED - Cabeleira, Manuel / Collaborator ED - Carbonara, Marco / Collaborator ED - Chieregato, Arturo / Collaborator ED - Citerio, Giuseppe / Collaborator ED - Clusmann, Hans / Collaborator ED - Czeiter, Endre / Collaborator ED - Czosnyka, Marek / Collaborator ED - Depreitere, Bart / Collaborator ED - Ercole, Ari / Collaborator ED - Frisvold, Shirin / Collaborator ED - Helbok, Raimund / Collaborator ED - Jankowski, Stefan / Collaborator ED - Kondziella, Daniel / Collaborator ED - Koskinen, Lars-Owe / Collaborator ED - Kowark, Ana / Collaborator ED - Menon, David K / Collaborator ED - Meyfroidt, Geert / Collaborator ED - Moeller, Kirsten / Collaborator ED - Nelson, David / Collaborator ED - Piippo-Karjalainen, Anna / Collaborator ED - Radoi, Andreea / Collaborator ED - Ragauskas, Arminas / Collaborator ED - Raj, Rahul / Collaborator ED - Rhodes, Jonathan / Collaborator ED - Rocka, Saulius / Collaborator ED - Rossaint, Rolf / Collaborator ED - Sahuquillo, Juan / Collaborator ED - Sakowitz, Oliver / Collaborator ED - Smielewski, Peter / Collaborator ED - Stocchetti, Nino / Collaborator ED - Sundström, Nina / Collaborator ED - Takala, Riikka / Collaborator ED - Tamosuitis, Tomas / Collaborator ED - Tenovuo, Olli / Collaborator ED - Unterberg, Andreas / Collaborator ED - Vajkoczy, Peter / Collaborator ED - Vargiolu, Alessia / Collaborator ED - Vilcinis, Rimantas / Collaborator ED - Wolf, Stefan / Collaborator ED - Younsi, Alexander / Collaborator ED - Zeiler, Frederick A / Collaborator TI - Modeling Brain-Heart Crosstalk Information in Patients with Traumatic Brain Injury. JF - NEUROCRITICAL CARE J2 - NEUROCRIT CARE VL - 36 PY - 2022 IS - 3 SP - 738 EP - 750 PG - 13 SN - 1541-6933 DO - 10.1007/s12028-021-01353-7 UR - https://m2.mtmt.hu/api/publication/33274555 ID - 33274555 N1 - Funding Agency and Grant Number: Universita degli Studi di Siena within the CRUI-CARE Agreement; European Union [602150] Funding text: Open access funding provided by Universita degli Studi di Siena within the CRUI-CARE Agreement. The study was supported by the European Union Seventh Framework Programme (Grant 602150) for CENTER-TBI. AB - Traumatic brain injury (TBI) is an extremely heterogeneous and complex pathology that requires the integration of different physiological measurements for the optimal understanding and clinical management of patients. Information derived from intracranial pressure (ICP) monitoring can be coupled with information obtained from heart rate (HR) monitoring to assess the interplay between brain and heart. The goal of our study is to investigate events of simultaneous increases in HR and ICP and their relationship with patient mortality..In our previous work, we introduced a novel measure of brain-heart interaction termed brain-heart crosstalks (ctnp), as well as two additional brain-heart crosstalks indicators [mutual information ([Formula: see text]) and average edge overlap (ωct)] obtained through a complex network modeling of the brain-heart system. These measures are based on identification of simultaneous increase of HR and ICP. In this article, we investigated the relationship of these novel indicators with respect to mortality in a multicenter TBI cohort, as part of the Collaborative European Neurotrauma Effectiveness Research in TBI high-resolution work package.A total of 226 patients with TBI were included in this cohort. The data set included monitored parameters (ICP and HR), as well as laboratory, demographics, and clinical information. The number of detected brain-heart crosstalks varied (mean 58, standard deviation 57). The Kruskal-Wallis test comparing brain-heart crosstalks measures of survivors and nonsurvivors showed statistically significant differences between the two distributions (p values: 0.02 for [Formula: see text], 0.005 for ctnp and 0.006 for ωct). An inverse correlation was found, computed using the point biserial correlation technique, between the three new measures and mortality: - 0.13 for ctnp (p value 0.04), - 0.19 for ωct (p value 0.002969) and - 0.09 for [Formula: see text] (p value 0.1396). The measures were then introduced into the logistic regression framework, along with a set of input predictors made of clinical, demographic, computed tomography (CT), and lab variables. The prediction models were obtained by dividing the original cohort into four age groups (16-29, 30-49, 50-65, and 65-85 years of age) to properly treat with the age confounding factor. The best performing models were for age groups 16-29, 50-65, and 65-85, with the deviance of ratio explaining more than 80% in all the three cases. The presence of an inverse relationship between brain-heart crosstalks and mortality was also confirmed.The presence of a negative relationship between mortality and brain-heart crosstalks indicators suggests that a healthy brain-cardiovascular interaction plays a role in TBI. LA - English DB - MTMT ER -