Current status of fluid biomarkers in mild traumatic brain injury

Exp Neurol. 2016 Jan;275 Pt 3(0 3):334-352. doi: 10.1016/j.expneurol.2015.05.004. Epub 2015 May 14.


Mild traumatic brain injury (mTBI) affects millions of people annually and is difficult to diagnose. Mild injury is insensitive to conventional imaging techniques and diagnoses are often made using subjective criteria such as self-reported symptoms. Many people who sustain a mTBI develop persistent post-concussive symptoms. Athletes and military personnel are at great risk for repeat injury which can result in second impact syndrome or chronic traumatic encephalopathy. An objective and quantifiable measure, such as a serum biomarker, is needed to aid in mTBI diagnosis, prognosis, return to play/duty assessments, and would further elucidate mTBI pathophysiology. The majority of TBI biomarker research focuses on severe TBI with few studies specific to mild injury. Most studies use a hypothesis-driven approach, screening biofluids for markers known to be associated with TBI pathophysiology. This approach has yielded limited success in identifying markers that can be used clinically, additional candidate biomarkers are needed. Innovative and unbiased methods such as proteomics, microRNA arrays, urinary screens, autoantibody identification and phage display would complement more traditional approaches to aid in the discovery of novel mTBI biomarkers.

Keywords: Biofluid; Biomarkers; Cerebral spinal fluid; Discovery; Mild traumatic brain injury; Novel; Serum; Unbiased.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Brain Injuries / blood*
  • Brain Injuries / chemically induced*
  • Brain Injuries / diagnosis
  • Humans
  • Inflammation Mediators / blood
  • Inflammation Mediators / cerebrospinal fluid
  • MicroRNAs / blood
  • MicroRNAs / cerebrospinal fluid
  • Military Personnel
  • Post-Concussion Syndrome / blood
  • Post-Concussion Syndrome / cerebrospinal fluid
  • Post-Concussion Syndrome / diagnosis


  • Biomarkers
  • Inflammation Mediators
  • MicroRNAs