Biomarkers of early brain injury have the potential to fundamentally improve neonatal care. Survival with a favorable neurological outcome is a key goal of neonatal medicine. Clinical decisions as well as research trials are often based on short term outcomes, with uncertain correlation to brain injury and long-term neurodevelopment. Potential uses of brain injury biomarkers include early detection of infants at risk of brain injury, selection for and direction of treatment, monitoring of treatment effect, evaluating extent and location of injury, guiding prognosis, and counselling, and predicting outcomes. However, despite many publications in recent years, neonatal brain injury biomarkers have yet to be implemented into clinical guidelines and are rarely used as primary outcomes in clinical trials. Why is this? Some of the best validated brain imaging biomarkers are not suitable for everyday use. Circulating markers may be non-specific and whilst many categories of biomarkers have been tested there is no consensus regarding which types of molecules warrant focus, timing of measurement, whether and how to combine several biomarkers, and whether the most optimal biomarker differs by etiology of neonatal brain injury. If this heterogenous area of research can be consolidated and results further validated, biomarkers of neonatal brain injury and neurodevelopment could become a cornerstone in personalized neonatal medicine.
The goal of this research topic is to update and consolidate the field of biomarkers of neonatal brain injury in preclinical and clinical settings. This includes both circulating biomarkers and imaging biomarkers, early biomarkers of acute injury and correlation with long-term neurodevelopment. The aim is to provide a foundation for future clinical implementation and research to guide neuroprotective care in neonatal medicine.
Types of manuscripts welcomed include original research, reviews and meta-analyses contributing to the goal of moving biomarkers of neonatal brain injury towards clinical implementation.
Neurodevelopment is a major concern in several conditions including but not limited to preterm birth, intrauterine growth restriction, periventricular leukomalacia, white matter injury, neonatal encephalopathy, and hypoxic ischemic encephalopathy.
Areas of focus to further the field include
• Acute markers identifying infants at risk and guiding treatment decisions
• Biomarkers correlating with long term neurodevelopment and other relevant neurological outcomes
• Validation of previous findings in larger cohorts
• Cross-disease validation of biomarkers
• Technical issues impacting clinical implementation
• Prediction approaches combining artificial intelligence and biomarkers
• Biomarker qualification to serve as surrogate endpoints for neurotherapeutic trials, facilitating drug development
The goals and challenges are overlapping for different classes of biomarkers, and brain injury biomarkers of interest may include imaging biomarkers as well as circulating biochemical biomarkers, electrophysiology, or clinical tests. The area of circulating biomarkers includes both RNA, metabolomics, proteomics, cytokines, and brain specific proteins. Unsolved issues include reference values in different body fluids, the use of single vs serial assessment and panels of markers. We will aim to focus on biomarkers which has been validated in multiple cohorts which can feasibly move into clinical care.
Biomarkers of early brain injury have the potential to fundamentally improve neonatal care. Survival with a favorable neurological outcome is a key goal of neonatal medicine. Clinical decisions as well as research trials are often based on short term outcomes, with uncertain correlation to brain injury and long-term neurodevelopment. Potential uses of brain injury biomarkers include early detection of infants at risk of brain injury, selection for and direction of treatment, monitoring of treatment effect, evaluating extent and location of injury, guiding prognosis, and counselling, and predicting outcomes. However, despite many publications in recent years, neonatal brain injury biomarkers have yet to be implemented into clinical guidelines and are rarely used as primary outcomes in clinical trials. Why is this? Some of the best validated brain imaging biomarkers are not suitable for everyday use. Circulating markers may be non-specific and whilst many categories of biomarkers have been tested there is no consensus regarding which types of molecules warrant focus, timing of measurement, whether and how to combine several biomarkers, and whether the most optimal biomarker differs by etiology of neonatal brain injury. If this heterogenous area of research can be consolidated and results further validated, biomarkers of neonatal brain injury and neurodevelopment could become a cornerstone in personalized neonatal medicine.
The goal of this research topic is to update and consolidate the field of biomarkers of neonatal brain injury in preclinical and clinical settings. This includes both circulating biomarkers and imaging biomarkers, early biomarkers of acute injury and correlation with long-term neurodevelopment. The aim is to provide a foundation for future clinical implementation and research to guide neuroprotective care in neonatal medicine.
Types of manuscripts welcomed include original research, reviews and meta-analyses contributing to the goal of moving biomarkers of neonatal brain injury towards clinical implementation.
Neurodevelopment is a major concern in several conditions including but not limited to preterm birth, intrauterine growth restriction, periventricular leukomalacia, white matter injury, neonatal encephalopathy, and hypoxic ischemic encephalopathy.
Areas of focus to further the field include
• Acute markers identifying infants at risk and guiding treatment decisions
• Biomarkers correlating with long term neurodevelopment and other relevant neurological outcomes
• Validation of previous findings in larger cohorts
• Cross-disease validation of biomarkers
• Technical issues impacting clinical implementation
• Prediction approaches combining artificial intelligence and biomarkers
• Biomarker qualification to serve as surrogate endpoints for neurotherapeutic trials, facilitating drug development
The goals and challenges are overlapping for different classes of biomarkers, and brain injury biomarkers of interest may include imaging biomarkers as well as circulating biochemical biomarkers, electrophysiology, or clinical tests. The area of circulating biomarkers includes both RNA, metabolomics, proteomics, cytokines, and brain specific proteins. Unsolved issues include reference values in different body fluids, the use of single vs serial assessment and panels of markers. We will aim to focus on biomarkers which has been validated in multiple cohorts which can feasibly move into clinical care.