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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neurotrauma
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1518776

Evaluating NfL and NTproBNP as predictive biomarkers of intracranial injuries after mild traumatic brain injury in children presenting to emergency departments

Provisionally accepted
Anne-Cécile CHIOLLAZ Anne-Cécile CHIOLLAZ 1*Virginie Pouillard Virginie Pouillard 2Michelle Seiler Michelle Seiler 3Céline Habre Céline Habre 2Fabrizio Romano Fabrizio Romano 4Céline Ritter Schenk Céline Ritter Schenk 5Fabian Spigariol Fabian Spigariol 6Christian Korff Christian Korff 2Fabienne Maréchal Fabienne Maréchal 2Verena Wyss Verena Wyss 4Lyssia Gruaz Lyssia Gruaz 1Joan Montaner Joan Montaner 7Jean-charles Sanchez Jean-charles Sanchez 1Sergio Manzano Sergio Manzano 2
  • 1 University of Geneva, Geneva, Switzerland
  • 2 Hôpitaux universitaires de Genève (HUG), Genève, Geneva, Switzerland
  • 3 University Children's Hospital Zurich, Zurich, Switzerland
  • 4 Inselspital University Hospital Bern, Bern, Bern, Switzerland
  • 5 Fribourg Cantonal Hospital, Friborg, Switzerland
  • 6 Réseau Hospitalier Neuchâtelois (RHNE), Neuchatel, Switzerland
  • 7 Institute of Biomedicine of Seville, Spanish National Research Council (CSIC), Seville, Spain

The final, formatted version of the article will be published soon.

    Objective: Blood-biomarkers have the potential to aid clinicians in pediatric emergency departments (PED) in managing children with mild traumatic brain injury (mTBI) acutely. However, studies focusing on pediatric populations remain limited. We aim to assess the performances of two routinely used biomarkers in other fields: the neurofilament light chain protein (NfL), and the N-terminal prohormone of brain natriuretic peptide (NTproBNP), to safely discharge children without intracranial injuries (ICIs).Methods: A prospective multicenter cohort study was conducted, enrolling children suffering from mTBI, both with and without imaging during their acute management in the PED. A blood sample was collected within 24 h post-trauma for biomarker analysis. Inclusion criteria followed the PECARN (Pediatric Emergency Care Applied Research Network) guidelines for the diagnosis of mTBI and for ICI on CT as the primary outcome (CT+).Results: A total of 302 mTBI patients were analyzed comparing children with ICI (18 CT+) versus all the other children without ICI (54 CTand 230 in-hospital-observation patients without CT). NfL and NTproBNP were increased in the CT+ group and their performances to safely rule-out patient without ICI reached up to 30% specificity with 100% sensitivity. Equivalent performances were observed whether selecting patients with blood collection within 6 h or 24 h post-trauma.Conclusion: NfL and NTproBNP were described for the first time in children suffering mTBI. Their performances were comparable to well-known biomarkers, such as S100b, GFAP, or HFABP, with the benefit of already being used in routine tests for other diseases. Further large-scale studies are necessary to verify and validate these results.

    Keywords: Blood-biomarkers, MTBI, pediatric, emergency, diagnosis

    Received: 28 Oct 2024; Accepted: 15 Jan 2025.

    Copyright: © 2025 CHIOLLAZ, Pouillard, Seiler, Habre, Romano, Schenk, Spigariol, Korff, Maréchal, Wyss, Gruaz, Montaner, Sanchez and Manzano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Anne-Cécile CHIOLLAZ, University of Geneva, Geneva, Switzerland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.