Diagnostic and prognostic role of serum/plasma and CSF amyloid beta peptide levels in traumatic brain injury: a systematic review and meta-analysis.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Fateme Mohammadifard, Sepehr Aghajanian, Ida Mohammadi, Shahryar Rajai Firouzabadi, Ali Baradaran Bagheri, Aladine A Elsamadicy
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引用次数: 0

Abstract

Amyloid beta (Aβ) peptides, particularly Aβ1-40 and Aβ1-42, have been implicated in TBI pathology as potential biomarkers for diagnosis and prognosis. This systematic review and meta-analysis aimed to evaluate differences in Aβ levels between TBI and non-TBI populations and their prognostic utility in both acute and chronic phases of TBI. A systematic search of MEDLINE, Scopus, and Web of Science was conducted up to October, 2024, with an updated search in July 2025. Studies assessing Aβ1-40 or Aβ1-42 in cerebrospinal fluid (CSF) or plasma of adults with TBI were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed for between-group comparisons, with subgroup analyses based on biological compartment and sampling interval. 25 studies were included in the review and 11 underwent quantitative synthesis. Qualitative evaluation of studies suggested a positive correlation between Aβ1-42 and neurological status in moderate to severe TBI but not mild TBI or concussion. Plasma Aβ1-42 levels were significantly elevated in TBI patients within 24 h post-injury (SMD:0.91, 95%CI: [0.15-1.66 No significant differences were observed in CSF (SMD:-0.37, 95%CI: [-0.88-0.15]) or plasma Aβ1-42 (SMD:0.09, 95%CI: [-0.07-0.26]) or Aβ1-40 (SMD:0.10 95%CI: [-0.25-0.44]) levels beyond the first year following TBI. Aβ peptides, particularly Aβ1-42, appear to change acutely in plasma post-TBI but show no consistent long-term alterations in either plasma or CSF. The limited and heterogeneous evidence suggests only modest prognostic potential, with no current support for their clinical use as reliable biomarkers for diagnosis or prognosis in TBI. Further large-scale, standardized studies are warranted.

血清/血浆和脑脊液淀粉样蛋白β肽水平在外伤性脑损伤中的诊断和预后作用:一项系统回顾和荟萃分析
淀粉样蛋白β (Aβ)肽,特别是Aβ1-40和Aβ1-42,作为诊断和预后的潜在生物标志物与TBI病理有关。本系统综述和荟萃分析旨在评估TBI和非TBI人群中Aβ水平的差异及其在TBI急性期和慢性期的预后价值。系统检索MEDLINE、Scopus和Web of Science,检索截止至2024年10月,并于2025年7月更新。研究评估了脑外伤成人脑脊液(CSF)或血浆中Aβ1-40或Aβ1-42的含量。偏倚风险采用纽卡斯尔-渥太华量表进行评估。对组间比较进行随机效应荟萃分析,并根据生物隔室和抽样间隔进行亚组分析。本综述纳入了25项研究,其中11项进行了定量综合。定性评价研究表明,a β1-42与中度至重度TBI患者的神经系统状态呈正相关,而与轻度TBI或脑震荡患者的神经系统状态无关。脑外伤患者在损伤后24小时内血浆a - β1-42水平显著升高(SMD:0.91, 95%CI:[0.15-1.66]),脑脊液(SMD:-0.37, 95%CI:[-0.88-0.15])或血浆a - β1-42 (SMD:0.09, 95%CI:[-0.07-0.26])或a - β1-40 (SMD:0.10 95%CI:[-0.25-0.44])水平在脑外伤后一年内无显著差异。Aβ肽,特别是Aβ1-42,似乎在脑外伤后血浆中发生了剧烈变化,但在血浆或脑脊液中没有显示出一致的长期变化。有限且异质性的证据表明其预后潜力有限,目前尚不支持其作为TBI诊断或预后的可靠生物标志物的临床应用。进一步的大规模、标准化研究是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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