Serum Biomarkers for Traumatic Peripheral Nerve Injury: A Systematic Review.

Abstract

Diagnosing the severity of a peripheral nerve injury or compression, and assessing its potential for recovery, remain clinical challenges. An objective and easily quantifiable serum-based biomarker that reflects axonal health would be a valuable diagnostic adjunct in the treatment of patients with peripheral nerve pathology. We therefore performed a review of the published literature using search strategies created for serum biomarkers and traumatic peripheral nerve injuries with both standardized index terms (i.e., MeSH, Emtree) and relevant key words. This yielded a total of 4626 combined results. Data was extracted from 12 studies (6 animal studies, 6 human studies). The biomarkers identified in this review ranged from axonal specific markers like neurofilament light chain (NfL) to more generalized markers such as lipid profiles and cytokines. The biomarker in this review deemed most promising for future use in the diagnosis and prognostication of peripheral nerve injury is serum NfL given its specificity for the nervous system and its dynamic behavior after nerve injury in animal models. Further work assessing its sensitivity and specificity to traumatic and compressive peripheral nerve injury may lay the foundation for widespread clinical use.