| Title: |
Associations of VEGF-A Levels with Traumatic Brain Injury Severity and Outcomes: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study |
| Authors: |
Thomas, Rachel; Demos, Catherine; Padmanabhan, Nikhil; Gorham, Taron; Sigal, George B.; Wohlstadter, Jacob N.; Lynch, Cillian; Jain, Sonia; Sun, Xiaoying; Giacino, Joseph T.; McCrea, Michael A.; Okonkwo, David O.; Robertson, Claudia S.; Temkin, Nancy; Mukherjee, Pratik; Wang, Kevin K.; Puccio, Ava M.; Schneider, Andrea L.C.; Sandsmark, Danielle K.; Manley, Geoffrey T.; Diaz-Arrastia, Ramon |
| Contributors: |
National Institute of Neurological Disorders and Stroke |
| Source: |
Neurotrauma Reports ; volume 7 ; ISSN 2689-288X 2689-288X |
| Publisher Information: |
SAGE Publications |
| Publication Year: |
2026 |
| Description: |
Biomarkers are needed to characterize mechanistic endophenotypes after neurotrauma and inform prognosis and therapy. Vascular endothelial growth factor-A (VEGF-A) is associated with inflammation and vascular permeability, which are implicated in secondary brain injury. We describe changes in plasma VEGF-A levels at injury (D1) and 2 weeks (W2) postinjury, and their associations with traumatic brain injury (TBI) severity and 6-month (M6) Glasgow Outcome Scale-Extended (GOSE) scores in a subset of Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) participants with TBI ( n = 317), orthopedic trauma controls (OTC, n = 82), and healthy controls (HC, n = 69). D1 VEGF-A levels were higher in TBI (median [IQR] = 175.8 [114.2–273.1]) compared with OTC (134.3 [97.4–200.6], p = 0.001) and HC (133.6 [89.2–188.2], p = 0.003). VEGF-A levels for both Glasgow Coma Scale (GCS) 3–12 (187.1 [131.7–271.6], p < 0.001) and GCS 13–15 with CT lesions (167.6 [111.4–273.9], p = 0.04) were significantly higher than control groups. This was not the case for GCS 13–15 without CT findings (160.5 [99.2–255.7], p = 0.11, p = 0.09 vs. HC and OTC, respectively). D1 levels did not significantly differ between GCS 3–12 and GCS 13–15 ( p = 0.09), but W2 VEGF-A levels remained elevated for GCS 3–12 (231.6 [120.2–511.5], p < 0.0001 vs. HC) while GCS 13–15 returned to HC levels. VEGF-A levels were higher in all TBI participants with intracranial pathology on CT compared with those without (D1: p = 0.024; W2: p < 0.0001). VEGF-A levels for all TBI returned to HC values by M6. D1 VEGF-A levels did not differ by M6 GOSE, but W2 levels were higher in those with moderate functional disability (GOSE 1–6; p = 0.04) and with unfavorable outcomes (GOSE 1–4; p < 0.0001). W2 VEGF-A was associated with increased odds of unfavorable outcome (GOSE 1–4) at M6 (aOR = 1.44 per log unit increase, 95% CI: 1.02–2.05) after accounting for demographic and clinical variables, but D1 levels were not. Our findings suggest that VEGF-A is a candidate ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1177/2689288x261427768 |
| DOI: |
10.1177/2689288X261427768 |
| Availability: |
https://doi.org/10.1177/2689288x261427768; https://journals.sagepub.com/doi/pdf/10.1177/2689288X261427768; https://journals.sagepub.com/doi/full-xml/10.1177/2689288X261427768 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ ; https://journals.sagepub.com/page/policies/text-and-data-mining-license |
| Accession Number: |
edsbas.A958EA72 |
| Database: |
BASE |