Plasma Phospholipid Metabolites Associate With Functional Outcomes Following Mild Traumatic Brain Injury in Older Adults

Biol Res Nurs. 2021 Jan;23(1):127-135. doi: 10.1177/1099800420942889. Epub 2020 Jul 22.


Objective: To compare differences using a metabolomics approach in older adults (≥55) with mild traumatic brain injury (mTBI) to control adults and to identify a signature profile related to functional outcome 3-6 months post-injury.

Methods: We performed metabolomics analysis using LC-MS of untargeted aqueous metabolites on plasma samples taken from a parent prospective cohort study. Older adults with mTBI (n = 14) were purposively sampled to include participants with worsening (decrease in GOS-E of at least 1 level) and improved (increase in GOS-E of at least 1 level) outcomes from 3 to 6 months. The data were analyzed using PLS-DA with VIP scores, Random Forest, and spline fit between the different groups as a function of time for exposure on outcome.

Results: Separation of comparisons were seen at 24 hours (negative ionization) and 6 months (positive ionization), revealing two metabolites of interest, phosphatidylcholine and phosphatidylethanolamine. Phosphatidylcholine levels were higher in those with mTBI compared to controls (p < 0.05), while lower concentration of phosphatidylethanolamine was seen in those with mTBI compared to controls (p < 0.05). Phosphatidylinositol-3,4,5-trisphosphate was significant in those with mTBI compared to controls (n = 10) based on improved (n = 6) versus worsened (n = 8) outcomes from 3 to 6 months.

Conclusion: We identified plasma metabolites related to phospholipid metabolism in older adults following mTBI and associated with long-term functional outcome. These findings may underly pathological mechanisms of outcome differences in older adults who experience mTBI.

Keywords: aged; head injury; metabolomics; phospholipids.

Publication types

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

MeSH terms

  • Aged
  • Brain Concussion / blood
  • Brain Concussion / physiopathology*
  • Female
  • Glasgow Outcome Scale
  • Humans
  • Male
  • Metabolomics
  • Middle Aged
  • Phospholipids / blood*
  • Prospective Studies


  • Phospholipids