Amery Frances Treble; PhD; Pediatric Psychology; Testing at Pediatric Neuropsychology in Lawrenceville; consent signed; portrait; NPI 1669920476
PITTSBURGH – Researchers at the University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh have unveiled a groundbreaking discovery in the field of pediatric traumatic brain injury (TBI). A new study, published in the Journal of Neurotrauma, identifies a promising biomarker that could revolutionize how complicated mild to severe pediatric TBI is diagnosed and treated.
The study is the first to pinpoint epigenetic modifications—specifically, changes in DNA that do not alter the genetic code but affect gene expression—as dynamic indicators of recovery after a brain injury. This advancement could pave the way for precision rehabilitation strategies tailored to individual patients.
Understanding the Science Behind the Discovery
The research focuses on the brain-derived neurotrophic factor (BDNF) gene, known for its role in neuroplasticity, or the brain’s ability to reorganize and heal after injury. Previous studies have linked BDNF levels to recovery outcomes in adults, but this is the first to explore its epigenetic modifications in children.
By analyzing DNA methylation, a type of epigenetic modification, scientists assessed whether BDNF methylation levels could serve as biomarkers reflecting both biological and psychosocial factors that influence recovery. The study involved blood samples from children with no prior history of TBI or neurological conditions, collected at various intervals after hospitalization at UPMC Children’s Hospital.
“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,” said Dr. Amery Treble-Barna, senior author and associate professor at Pitt School of Medicine.
Implications for Pediatric TBI Treatment
One of the study’s significant findings is that children with TBI exhibited different epigenetic profiles compared to those with orthopedic injuries. Specifically, their blood samples showed significantly less BDNF DNA methylation, with levels normalizing over time. Notably, the study did not find a correlation between BDNF methylation and TBI severity as measured by the Glasgow Coma Scale (GCS), suggesting that GCS may not fully capture recovery nuances.
“DNA methylation is dynamic and modifiable, which means it could respond not only to injury but also to interventions like diet, exercise, and therapy,” explained Dr. Lacey Heinsberg, lead author and assistant professor at Pitt’s School of Nursing.
The Broader Context of TBI Research
Traumatic brain injury is a leading cause of disability in children, influenced by a complex interplay of biological, psychological, and social factors. Pitt and UPMC have long been at the forefront of innovation in TBI diagnostics and recovery strategies, aiming to prevent premature death and reduce disability.
This study builds on the legacy of Pitt’s Safar Center for Resuscitation Research, contributing to the growing body of knowledge about TBI biomarkers in children. The research team is now expanding their work to examine DNA methylation across the entire genome and link these changes to long-term neurobehavioral outcomes.
Looking Ahead: Future Research and Clinical Applications
The discovery of this biomarker opens new avenues for research and clinical applications. By understanding the molecular underpinnings of pediatric TBI, healthcare providers can develop more targeted interventions that improve recovery trajectories.
UPMC Children’s Hospital of Pittsburgh continues to serve as a vital clinical partner in advancing pediatric neurotrauma care and research. The collaboration between experts in neuropsychology, nursing, genetics, and TBI research exemplifies the interdisciplinary approach needed to tackle complex medical challenges.
The study was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development and the National Institute of Neurological Disorders and Stroke. Other contributors include Aboli Kesbhat, Bailey Petersen, Ph.D., Lauren Kaseman, Zachary Stec, Nivinthiga Anton, Patrick Kochanek, M.D., Daniel Weeks, Ph.D., and Yvette Conley, Ph.D., from Pitt, and Keith Owen Yeates, Ph.D., from the University of Calgary.
For more information on this study and related research, visit the Genomics of Patient Outcomes HUB at the University of Pittsburgh School of Nursing, and explore resources available at UPMC Children’s Hospital.
