Biofluid-based predictors of post-concussion symptoms: a narrative review of mild traumatic brain injury biomarkers
Lyons, Hannah S Hubbard, Jessica C Thomas, Chloe N Roberts, James A Mugo, Caroline W Bellamy Plaice, Gabriel Grech, Olivia Prosser, Sophie Strom, Asha Lucas, Samuel J E
Lyons, Hannah S
Hubbard, Jessica C
Thomas, Chloe N
Roberts, James A
Mugo, Caroline W
Bellamy Plaice, Gabriel
Grech, Olivia
Prosser, Sophie
Strom, Asha
Lucas, Samuel J E
Affiliation
University of Birmingham; University Hospitals Birmingham NHS Foundation Trust; The University of Melbourne; Johns Hopkins University; Defence Medical Rehabilitation Centre
Other Contributors
Hampshire, Adam
Czarnecka, Agata
Abdel-Hay, Ahmed Fouad
Smith, Aimee R
Bryant, Alex
Mazaheri, Ali
Sitch, Alice J
Mannan, Aliyah
Chan, Altus
Yiangou, Andreas
Bagshaw, Andrew P
Palmer, Andrew
Hunter, Angus M
Ghose, Animesh
Krynicki, Carl R
Witton, Caroline
Nicholls, Cherie
Brown, Claire H
Anderson, Clare
Ford, Dan
Smullen, Danny
Smith, David J
Jimenez-Grande, David
Fernandez-Espejo, Davinia
Rowan-MacIndoe, Eleanor G
Lardner, Emma C
Dehghani, Hamid
Fisher, Hannah
Park, Hyojin
Varley, Ian
Tennant, Jacob H
Novak, Jan
Gavin, Jennie
Read, John T
Deeks, Jonathan J
Sulkowska, Julita
Mullinger, Karen J
Tester, Karen
Cox, Katherine L
Morris, Katie
Coughlan, Linda Martina
Balaet, Maria
Thaller, Mark
Hill, Matt
Mann, Mia
Akhtar, Nasreen
Jenkinson, Ned J
Winkles, Neil
Hellyer, Pete J
Reynolds, Raymond F
Blanch, Richard J
Ottridge, Ryan S
Qureshi, Sabrina
Berhane, Sarah
Mohan, Syama
Meredith, Thomas
Inns, Tom
Hyder, Yousef F
Czarnecka, Agata
Abdel-Hay, Ahmed Fouad
Smith, Aimee R
Bryant, Alex
Mazaheri, Ali
Sitch, Alice J
Mannan, Aliyah
Chan, Altus
Yiangou, Andreas
Bagshaw, Andrew P
Palmer, Andrew
Hunter, Angus M
Ghose, Animesh
Krynicki, Carl R
Witton, Caroline
Nicholls, Cherie
Brown, Claire H
Anderson, Clare
Ford, Dan
Smullen, Danny
Smith, David J
Jimenez-Grande, David
Fernandez-Espejo, Davinia
Rowan-MacIndoe, Eleanor G
Lardner, Emma C
Dehghani, Hamid
Fisher, Hannah
Park, Hyojin
Varley, Ian
Tennant, Jacob H
Novak, Jan
Gavin, Jennie
Read, John T
Deeks, Jonathan J
Sulkowska, Julita
Mullinger, Karen J
Tester, Karen
Cox, Katherine L
Morris, Katie
Coughlan, Linda Martina
Balaet, Maria
Thaller, Mark
Hill, Matt
Mann, Mia
Akhtar, Nasreen
Jenkinson, Ned J
Winkles, Neil
Hellyer, Pete J
Reynolds, Raymond F
Blanch, Richard J
Ottridge, Ryan S
Qureshi, Sabrina
Berhane, Sarah
Mohan, Syama
Meredith, Thomas
Inns, Tom
Hyder, Yousef F
Publication date
2025-12-18
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Abstract
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.
Citation
Lyons HS, Hubbard JC, Thomas CN, Roberts JA, Mugo CW, Bellamy Plaice G, Grech O, Prosser S, Strom A, Lucas SJE, Downie LE, Gill JM, Mitchell JL, Sinclair AJ, Hill LJ; UK mTBI-Predict Consortium. Biofluid-based predictors of post-concussion symptoms: a narrative review of mild traumatic brain injury biomarkers. Brain Commun. 2025 Dec 18;8(1):fcaf501. doi: 10.1093/braincomms/fcaf501.
Type
Article