Ability of S100B to predict post-concussion syndrome in paediatric patients who present to the emergency department with mild traumatic brain injury

Abstract

Introduction: Among children who sustain mild traumatic brain injury (mTBI), 10-30% develop a cluster of cognitive, physical, and emotional symptoms commonly referred to as post-concussion syndrome (PCS). Symptoms typically resolve within 7-10 days, but a minority of patients report symptoms that persist for months or even years. The aim of our study was to identify a neurobiochemical marker after mTBI that can predict the presence of post-concussion syndrome three months after head injury in paediatric patients.

Materials and methods: Children between 7 and 16 years of age who had head trauma and no other complaints were included. Three months after the initial visit, participants or parents/guardians were interviewed in person about the children's PCS symptoms using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ).

Results: The mean value of S100B protein in serum in 38 patients without signs of PCS was 0.266 μg L^-1, with a 95% confidence interval (CI) of 0.221 - 0.310 μg L^-1. Among the 22 patients with signs of PCS, the mean value of S100B protein in serum was 0.845 μg L^-1, with a 95% CI of 0.745-0.945 μg L^-1. Patients with signs of PCS had higher S100B protein levels than those without signs of PCS (p < 0.0001).

Conclusions: Our prospective study showed that S100B protein is a useful neurobiomarker for detecting paediatric patients at risk for post-concussion syndrome. We found that the biomarker S100B correlated with the severity of traumatic brain injury (number of lesions on CT) and the presence of post-concussion syndrome.

Keywords: Post-concussion syndrome; head CT; mild traumatic brain injury; paediatric population.