Research Reports - Acute inflammatory biomarker profiles predict depression risk following moderate to severe traumatic brain injury

J Head Trauma Rehabil. 2014 Feb 28

Juengst SB(1), Kumar RG, Failla MD, Goyal A, Wagner AK

OBJECTIVE:: To examine whether acute inflammation profiles predict posttraumatic
depression (PTD) risk 6 and 12 months after traumatic brain injury.
SETTING:: University-affiliated level 1 trauma center and community.
PARTICIPANTS:: Adults with moderate to severe traumatic brain injury (acute serum
levels: n = 50; acute cerebrospinal fluid (CSF) levels: n = 41).
DESIGN:: Prospective cohort study.
MAIN MEASURES:: Patient Health Questionnaire; inflammatory biomarkers
(interleukin [IL]-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, tumor necrosis
factor α, soluble vascular adhesion molecule [sVCAM-1], soluble intracellular
adhesion molecule [sICAM-1], soluble Fas [sFAS]).
RESULTS:: Higher levels of acute CSF cytokine surface markers (sVCAM-1, sICAM-1,
and sFAS) in an inflammatory biomarker risk (IBR) score were associated with a
3.920-fold increase in the odds of developing PTD at 6 months (95% confidence
interval: 1.163-8.672). Having sICAM-1, sVCAM-1, or sFAS above the 75th
percentile had a positive predictive value of 85.7% for PTD risk at 6 months. An
IBR score including inflammatory biomarkers IL-7 and IL-8 showed a trending
association with 12-month PTD risk (odds ratio = 3.166, 95% confidence interval:
0.936-10.708).
CONCLUSION:: Acute CSF IBR scores show promise for identifying individuals at
risk for PTD. Further research should assess acute CSF inflammatory biomarkers'
relationships to chronic inflammation as a mechanism of PTD and should explore
anti-inflammatory treatments for PTD, as well as prevention and screening
protocols, and link inflammatory biomarkers to symptom tracking.

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