Emerging Biomarkers of Neurotrauma

The prevalence of neurotrauma and associated long-term clinical sequelae has created a worrisome public health challenge known as the “silent epidemic”. Early detection and assessment are essential for the timely intervention and mitigation of long-term health consequences. Current clinical practice for the assessment of neurotrauma often involves a combination of neuropsychological evaluations, acute injury surveillance, and medical imaging. These methods offer significant opportunity for improvement given their subjective measures, insensitivity to mild injuries, and poor applicability in the field. These limitations have created an urgent need to develop new biomarkers capable of objective neurotrauma characterization.

The success of biomarker discovery using “omics”-based approaches in other diseases and conditions has recently prompted an intense interest to develop novel biomarkers of neurotrauma. In addition, efforts to unravel the pathophysiology of neurotrauma has revealed a complex cascade of events that lead to ionic flux, indiscriminate excitatory neurotransmitter release, increased glycolysis, and oxidative stress as well as structural and physiological changes such as altered cerebral blood flow and diffuse axonal injury. Together, our improved understanding of the underlying pathophysiology of neurotrauma and application of “omics”-based approaches to neurotrauma has resulted in the rapid emergence of novel biomarkers across multiple domains, including neuroimaging biomarkers using imaging modalities, neurophysiological biomarkers using electroencephalography, magnetoencephalography, and oculomotor assessments, molecular biomarkers including proteins, metabolites, and exosomes found in various bodily fluids, and digital biomarkers from wearable devices. The development and validation of these candidate biomarkers remain a key challenge to their application to clinical practice.

This special issue aims to highlight the development and validation of neurotrauma biomarkers, including: 1) biomarker discovery, involving neuroimaging, molecular, neurophysiological, and digital biomarkers; 2) novel applications of neurotrauma biomarkers to early detection, risk characterization, therapeutic response prediction, and therapeutic response monitoring; and 3) advances to overcome technical barriers to the field, including the development of advanced quantitative techniques, design of prospective clinical studies to identify and validate biomarkers in neurotrauma populations, and development of multi-modal techniques. In this way, this special issue seeks to capture the latest advances in the development and validation of neurotrauma biomarkers for the clinical detection and management of neurotrauma. We encourage high-quality papers containing original research results as well as review articles of exceptional merit.