Serum Biomarkers Predict Acute Symptom Burden in Children after Concussion: A Preliminary Study

Pediatric emergency department (ED) visits for concussion have nearly tripled in the past decade. Despite this, there are limited bedside tools available to objectively diagnose injury and prognosticate recovery. Here, we perform a preliminary evaluation of the utility of glial fibrillary acidic protein (GFAP) in predicting initial and follow-up symptom burden in children and young adults 11-21 years of age, presenting to the ED after concussion. We enrolled 13 children and young adults presenting to the ED within 24 h of concussion, and obtained initial serum samples at that time as well as follow-up samples within 24-72 h of injury. Initial GFAP levels were associated with initial and follow-up symptom burden up to 1 month after injury, whereas follow-up GFAP levels did not correlate with symptom burden. These preliminary data suggest that GFAP may offer an objective measure of injury and recovery after pediatric concussion, potentially offering clinicians a new tool in the management of this common injury.