Publication Date
1-1-2022
Journal
Frontiers in Pharmacology
DOI
10.3389/fphar.2022.713100
PMID
35370671
PMCID
PMC8966615
PubMedCentral® Posted Date
3-16-2022
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
precision medicine, traumatic brain injury, biomarkers, neuromonitoring, genomics and epigenomics
Abstract
Traumatic brain injury remains a leading cause of death and disability across the globe. Substantial uncertainty in outcome prediction continues to be the rule notwithstanding the existing prediction models. Additionally, despite very promising preclinical data, randomized clinical trials (RCTs) of neuroprotective strategies in moderate and severe TBI have failed to demonstrate significant treatment effects. Better predictive models are needed, as the existing validated ones are more useful in prognosticating poor outcome and do not include biomarkers, genomics, proteonomics, metabolomics, etc. Invasive neuromonitoring long believed to be a "game changer" in the care of TBI patients have shown mixed results, and the level of evidence to support its widespread use remains insufficient. This is due in part to the extremely heterogenous nature of the disease regarding its etiology, pathology and severity. Currently, the diagnosis of traumatic brain injury (TBI) in the acute setting is centered on neurological examination and neuroimaging tools such as CT scanning and MRI, and its treatment has been largely confronted using a "one-size-fits-all" approach, that has left us with many unanswered questions. Precision medicine is an innovative approach for TBI treatment that considers individual variability in genes, environment, and lifestyle and has expanded across the medical fields. In this article, we briefly explore the field of precision medicine in TBI including biomarkers for therapeutic decision-making, multimodal neuromonitoring, and genomics.
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Neurology Commons, Neurosciences Commons, Psychiatric and Mental Health Commons, Psychoanalysis and Psychotherapy Commons, Trauma Commons