Research paves way for precision therapy for childhood TBI

Researchers found a paediatric TBI biomarker that could guide precision rehabilitation after traumatic brain injury (TBI).

The study identified reversible DNA changes, called epigenetic modifications, that may act as dynamic markers of recovery.

Complicated traumatic brain injury usually requires at least an overnight hospital stay, unlike concussion, which often resolves within weeks.

The research was conducted by teams at the University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh.

Amery Treble-Barna is associate professor of physical medicine and rehabilitation at Pitt School of Medicine.

The researcher said: “This research brings us closer to understanding how children’s brains respond to injury at the molecular level and how those changes relate to real-world functioning.

“As a neuropsychologist, I look beyond whether a child can return to school or basic independence.

“Combining nuanced cognitive and behavioural data with molecular insights allows us to lay the groundwork for personalised care and advance precision rehabilitation in paediatric patients.”

Scientists analysed blood from children with no prior TBI or neurological conditions, taken over hours, days and months after hospitalisation.

They focused on the BDNF gene because of its role in neuroplasticity, the brain’s ability to reorganise and heal.

Children with TBI showed a different epigenetic profile than those with orthopaedic injuries, with significantly less BDNF DNA methylation.

Levels stabilised and matched controls by 12 months after injury.

Researchers did not find correlations between BDNF DNA methylation and TBI severity measured by the Glasgow Coma Scale, a tool for assessing consciousness, suggesting the scale does not capture the full picture of recovery.

Lacey Heinsberg, assistant professor at Pitt’s School of Nursing, said: “DNA methylation is dynamic and modifiable, which means it could respond not only to injury but also to interventions like diet, exercise and therapy.

“This opens the door to future research on how we might actively improve recovery trajectories for kids with TBI.”

The team is expanding work to examine DNA methylation across the whole genome and to link changes to long-term neurobehavioural outcomes.