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Saliva RNA biomarkers predict concussion duration and detect symptom recovery: a comparison with balance and cognitive testing
- Source :
- Journal of Neurology
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Objective The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance. Methods RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8–24-years-old) with mild traumatic brain injury (mTBI). Initial samples were obtained ≤ 14 days post-injury, and follow-up samples were obtained ≥ 21 days post-injury. Computerized balance and cognitive test performance were assessed at initial and follow-up time-points. Machine learning was used to define: (1) a model employing initial ncRNA levels to predict persistent post-concussion symptoms (PPCS) ≥ 21 days post-injury; and (2) a model employing follow-up ncRNA levels to identify symptom recovery. Performance of the models was compared against a validated clinical prediction rule, and balance/cognitive test performance, respectively. Results An algorithm using age and 16 ncRNAs predicted PPCS with greater accuracy than the validated clinical tool and demonstrated additive combined utility (area under the curve (AUC) 0.86; 95% CI 0.84–0.88). Initial balance and cognitive test performance did not differ between PPCS and non-PPCS groups (p > 0.05). Follow-up balance and cognitive test performance identified symptom recovery with similar accuracy to a model using 11 ncRNAs and age. A combined model (ncRNAs, balance, cognition) most accurately identified recovery (AUC 0.86; 95% CI 0.83–0.89). Conclusions ncRNA biomarkers show promise for tracking recovery from mTBI, and for predicting who will have prolonged symptoms. They could provide accurate expectations for recovery, stratify need for intervention, and guide safe return-to-activities.
- Subjects :
- Adult
Oncology
medicine.medical_specialty
Neurology
Adolescent
Traumatic brain injury
Clinical prediction rule
Neuropsychological Tests
Young Adult
03 medical and health sciences
0302 clinical medicine
return to play
mTBI
030225 pediatrics
Internal medicine
spit
Concussion
medicine
Humans
Child
Saliva
Brain Concussion
Balance (ability)
Original Communication
microRNA
business.industry
traumatic brain injury
Area under the curve
Cognition
medicine.disease
Cognitive test
RNA
prognosis
Neurology (clinical)
business
Biomarkers
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14321459 and 03405354
- Volume :
- 268
- Database :
- OpenAIRE
- Journal :
- Journal of Neurology
- Accession number :
- edsair.doi.dedup.....90778097a379f7c1c6aa0383d1ca3250