TY - JOUR
T1 - Biofluid-based predictors of post-concussion symptoms
T2 - A narrative review of mild traumatic brain injury biomarkers
AU - Lyons, Hannah S.
AU - Hubbard, Jessica C.
AU - Thomas, Chloe N.
AU - Roberts, James A.
AU - Mugo, Caroline W.
AU - Bellamy Plaice, Gabriel
AU - Grech, Olivia
AU - Prosser, Sophie
AU - Strom, Asha
AU - Lucas, Samuel J.E.
AU - Downie, Laura E.
AU - Gill, Jessica M.
AU - Mitchell, James L.
AU - Sinclair, Alexandra J.
AU - Hill, Lisa J.
AU - Hampshire, Adam
AU - Czarnecka, Agata
AU - Abdel-Hay, Ahmed Fouad
AU - Smith, Aimee R.
AU - Bryant, Alex
AU - Mazaheri, Ali
AU - Sitch, Alice J.
AU - Mannan, Aliyah
AU - Chan, Altus
AU - Yiangou, Andreas
AU - Bagshaw, Andrew P.
AU - Palmer, Andrew
AU - Hunter, Angus M.
AU - Ghose, Animesh
AU - Krynicki, Carl R.
AU - Witton, Caroline
AU - Nicholls, Cherie
AU - Brown, Claire H.
AU - Anderson, Clare
AU - Ford, Dan
AU - Smullen, Danny
AU - Jimenez-Grande, David
AU - Fernandez-Espejo, Davinia
AU - Rowan-Macindoe, Eleanor G.
AU - Lardner, Emma C.
AU - Dehghani, Hamid
AU - Fisher, Hannah
AU - Park, Hyojin
AU - Varley, Ian
AU - Tennant, Jacob H.
AU - Novak, Jan
AU - Gavin, Jennie
AU - Read, John T.
AU - Deeks, Jonthan J.
AU - Sulkowska, Julita
AU - Mullinger, Karen J.
AU - Tester, Karen
AU - Cox, Katherine L.
AU - Morris, Katie
AU - Coughlan, Linda Martina
AU - Balaet, Maria
AU - Thaller, Mark
AU - Hill, Matt
AU - Mann, Mia
AU - Akhtar, Nasreen
AU - Jenkinson, Ned J.
AU - Winkles, Neil
AU - Hellyer, Pete J.
AU - Reynolds, Raymond F.
AU - Blanch, Richard J.
AU - Ottridge, Ryan S.
AU - Qureshi, Sabrina
AU - Berhane, Sarah
AU - Mohan, Syama
AU - Meredith, Thomas
AU - Inns, Tom
AU - Hyder, Yousef F.
N1 - © The Author(s) 2025. Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse,
distribution, and reproduction in any medium, provided the original work is properly cited.
PY - 2025/12/18
Y1 - 2025/12/18
N2 - Mild traumatic brain injury can disrupt brain function and is associated with high morbidity and healthcare utilization. While many individuals recover from mild traumatic brain injury, a significant proportion experience long-term sequelae, collectively known as post-concussion syndrome. Symptoms of post-concussion syndrome include headache, dizziness, insomnia, cognitive processing difficulties and mental health disturbances. The disease burden is augmented by the current lack of objective measures to accurately predict long-term symptoms and deficits, providing an opportunity to utilize biomarkers in biofluids. A large proportion of available diagnostic clinical tools are subjective symptom scores. This review aims to explore current fluid biomarkers, grouped by clinical symptoms. With the available literature, we have discovered a wide range of fluid biomarkers that have been investigated for predicting post-traumatic headache, including neuropeptides; sleep disturbances, such as cortisol and melatonin; vestibular disturbances, including interleukin-6 and neurone-specific enolase; and vomiting, such as S100B. Along with physical symptoms, biomarkers investigated for predicting cognitive disturbances include inflammatory markers, S100B, neurofilament light chain, tau, microRNA and hormones. Biomarkers to predict mental health disturbances may include brain-derived neurotrophic factor, tau and cortisol. By utilizing such biomarkers, there is capacity to adopt a personalized medicine approach to facilitate early interventions for those most in need while also identifying individuals with a favourable prognosis who can safely return to their normal activities.
AB - Mild traumatic brain injury can disrupt brain function and is associated with high morbidity and healthcare utilization. While many individuals recover from mild traumatic brain injury, a significant proportion experience long-term sequelae, collectively known as post-concussion syndrome. Symptoms of post-concussion syndrome include headache, dizziness, insomnia, cognitive processing difficulties and mental health disturbances. The disease burden is augmented by the current lack of objective measures to accurately predict long-term symptoms and deficits, providing an opportunity to utilize biomarkers in biofluids. A large proportion of available diagnostic clinical tools are subjective symptom scores. This review aims to explore current fluid biomarkers, grouped by clinical symptoms. With the available literature, we have discovered a wide range of fluid biomarkers that have been investigated for predicting post-traumatic headache, including neuropeptides; sleep disturbances, such as cortisol and melatonin; vestibular disturbances, including interleukin-6 and neurone-specific enolase; and vomiting, such as S100B. Along with physical symptoms, biomarkers investigated for predicting cognitive disturbances include inflammatory markers, S100B, neurofilament light chain, tau, microRNA and hormones. Biomarkers to predict mental health disturbances may include brain-derived neurotrophic factor, tau and cortisol. By utilizing such biomarkers, there is capacity to adopt a personalized medicine approach to facilitate early interventions for those most in need while also identifying individuals with a favourable prognosis who can safely return to their normal activities.
KW - biofluids
KW - biomarkers
KW - mTBI
KW - post-concussion syndrome
UR - http://www.scopus.com/inward/record.url?scp=105028282569&partnerID=8YFLogxK
UR - https://academic.oup.com/braincomms/article/8/1/fcaf501/8383851
U2 - 10.1093/braincomms/fcaf501
DO - 10.1093/braincomms/fcaf501
M3 - Review article
AN - SCOPUS:105028282569
SN - 2632-1297
VL - 8
JO - Brain Communications
JF - Brain Communications
IS - 1
M1 - fcaf501
ER -