Free Thyroxine (fT4) as a Potential Biomarker of Neurological and Functional Outcome in Acquired Brain Injury: A Prospective Multicenter Cohort Study

被引:1
作者
Mele, Chiara [1 ]
Bagnato, Sergio [2 ,3 ]
De Tanti, Antonio [4 ]
Lucca, Lucia Francesca [5 ]
Saviola, Donatella [4 ]
Marcuccio, Laura [6 ]
Moretta, Pasquale [6 ]
Scarponi, Federico [7 ]
Losavio, Ernesto [8 ]
Picciola, Emilia [8 ]
Pingue, Valeria [9 ]
机构
[1] Univ Pavia, Dept Clin Surg Diagnost & Pediat Sci, I-27100 Pavia, Italy
[2] Giuseppe Giglio Fdn, Rehabil Dept, Unit Neurophysiol, I-90015 Cefalu, Italy
[3] Giuseppe Giglio Fdn, Rehabil Dept, Unit Severe Acquired Brain Injuries, I-90015 Cefalu, Italy
[4] Cardinal Ferrari Ctr, Santo Stefano Riabilitaz KOS CARE, I-43012 Fontanellato, Italy
[5] S Anna Inst, IT-88900 Crotone, Italy
[6] Ist Clin Sci Maugeri IRCCS, Neurorehabil Unit, Telese Terme Inst, I-82037 Telese Terme, Italy
[7] San Giovanni Battista Hosp, Dept Rehabil, I-06034 Foligno, Italy
[8] Ist Clin Sci Maugeri IRCCS, Neurorehabil & Spinal Unit, Bari Inst, I-70124 Bari, Italy
[9] Ist Clin Sci Maugeri IRCCS, Pavia Inst, Neurorehabil & Spinal Unit, I-27100 Pavia, Italy
关键词
acquired brain injury; thyroid hormones; biomarker; rehabilitation; outcome; THYROID-HORMONE; OXIDATIVE STRESS; CEREBRAL-CORTEX; GLOBAL BURDEN; IN-VIVO; EXPRESSION; DISEASE;
D O I
10.3390/jcm12237433
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The potential involvement of thyroid hormones (THs) in the neurological and functional recovery of patients with brain damage has been hypothesized. We aimed at investigating the role of THs and their variations during the rehabilitation process as predictive biomarkers of neurological and functional outcome in patients with acquired brain injury (ABI). This prospective, multicenter cohort study included 220 patients with ABI consecutively admitted for a 6-month neurorehabilitation program. Data on the etiology of the brain injury, occurrence of seizures, neurosurgical procedures, and death during hospitalization were collected. Both at the baseline (T0) and at the end of the rehabilitation process (T1), the following variables were evaluated: thyroid function (TSH, fT4, and fT3) and outcome measure including the Glasgow Coma Scale (GCS), Glasgow Outcome Scale-Extended (GOS-E), and Functional Independence Measure (FIM) scale. During neurorehabilitation, a significant decrease in fT4 levels was documented in the population as a whole and in patients with severe ABI (p < 0.0001), whereas no significant variations were found in TSH and fT3 levels. No significant associations were found between THs and seizure occurrence, while the neurological and functional outcomes were associated with the variation in fT4 levels during rehabilitation. In particular, a higher magnitude of decrease in fT4 levels emerged as an independent predictor of more severe neurological damage (OR = 3.48, CI 95% 1.04-11.69, p = 0.04) and a lower functional recovery (beta = -0.22, p = 0.01). In conclusion, serum fT4 variation during neurorehabilitation could represent a potential biomarker of neurological and functional outcome in patients with ABI. Further studies are needed to investigate the mechanisms underlying this association.
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页数:11
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