Amery Frances Treble; PhD; Pediatric Psychology; Testing at Pediatric Neuropsychology in Lawrenceville; consent signed; portrait; NPI 1669920476
PITTSBURGH – In a significant advancement for pediatric healthcare, researchers at the University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh have identified a promising new biomarker for “complicated” mild to severe pediatric traumatic brain injury (TBI). This discovery, published today in the Journal of Neurotrauma, could revolutionize how recovery is monitored and managed in young patients.
Unlike concussions, which typically resolve within weeks, complicated TBIs necessitate at least an overnight hospital stay, indicating a more severe injury. The study is groundbreaking as it identifies epigenetic modifications—reversible chemical changes to DNA—as potential indicators of recovery and guides for precision rehabilitation strategies.
Understanding the Molecular Response to Brain Injury
The research, led by Dr. Amery Treble-Barna, an associate professor at Pitt School of Medicine, delves into how children’s brains respond to injury at a molecular level. “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. Treble-Barna. By integrating cognitive and behavioral data with molecular insights, the study paves the way for personalized care in pediatric TBI patients.
Traumatic brain injury remains a leading cause of disability among children, influenced by a complex interplay of biological, psychological, and social factors. Pitt and UPMC have been at the forefront of neurotrauma research, driving innovations in diagnostics and recovery strategies for both children and adults.
The Role of BDNF in Recovery
Building on decades of innovation at Pitt’s Safar Center for Resuscitation Research, the study focuses on the brain-derived neurotrophic factor (BDNF) gene, known for its role in neuroplasticity. Neuroplasticity is the brain’s ability to reorganize and heal post-injury. While previous studies have linked BDNF levels to recovery outcomes in adults, this is the first to explore its epigenetic modifications in children.
Researchers concentrated on DNA methylation, a well-studied type of epigenetic modification, to determine if BDNF methylation levels could serve as biomarkers reflecting both biological and psychosocial recovery factors. Blood samples from children with no prior TBI history were analyzed over time, revealing that TBI patients had significantly less BDNF DNA methylation compared to those with orthopedic injuries. These levels stabilized to match the control group within a year.
Implications for Future Treatment
Interestingly, the study found no correlation between BDNF DNA methylation and TBI severity as measured by the Glasgow Coma Scale (GCS), a commonly used consciousness assessment tool. This finding challenges the GCS’s effectiveness in representing the full recovery picture.
“DNA methylation is dynamic and modifiable, which means it could respond not only to injury but also to interventions like diet, exercise, and therapy,” said Dr. Lacey Heinsberg, lead author of the study and assistant professor at Pitt’s School of Nursing.
The research team is now expanding their work to examine DNA methylation across the entire genome, aiming to link these changes to long-term neurobehavioral outcomes. This could potentially lead to interventions that actively improve recovery trajectories for children with TBI.
Collaboration and Future Directions
The study underscores Pitt’s leadership in epigenetic and neurotrauma research, highlighting the collaboration between experts in TBI, neuropsychology, nursing, and genetics. UPMC Children’s Hospital of Pittsburgh plays a crucial role as a clinical partner in advancing pediatric neurotrauma care and research.
For those interested in exploring the study further, resources are available through the Genomics of Patient Outcomes HUB at the University of Pittsburgh, UPMC Children’s Hospital, and other related institutions.
Other contributors to the research 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., all from Pitt, and Keith Owen Yeates, Ph.D., from the University of Calgary, Canada. 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.
