Blood-Based Biomarkers and Cognitive-Behavioral Assessment in Mild Traumatic Brain Injury: Current Evidence and Clinical Perspectives.

Abstract

Mild traumatic brain injury (mTBI) comprises the majority of all traumatic brain injuries, but clinical evaluation remains challenging because conventional neuroimaging cannot adequately detect subtle structural abnormalities or explain functional disturbances. Blood-based biomarkers have been studied as indicators of tissue injury. They may help reduce unnecessary computed tomography scans and predict unfavorable outcomes. However, biomarkers still have limitations in accurately assessing cognitive and behavioral abnormalities. Cognitive and behavioral evaluation helps characterize the functional consequences of mTBI, including impairments in attention, memory, executive function, and emotional symptoms. Although a range of cognitive and behavioral assessment tools is available, their interpretation is also influenced by factors such as timing, comorbidities, and patient effort. Taken together, blood-based biomarkers and cognitive and behavioral assessment should be interpreted in combination to allow a more comprehensive evaluation of the patients with mTBI. In this review, we summarize blood-based biomarkers and cognitive and behavioral assessment tools in mTBI, discuss their limitations, and propose an integrated approach to support more precise and individualized patient management.