{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:33:26Z","timestamp":1793428406115,"version":"4.5.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Neurogenic heterotopic ossification (NHO) after traumatic brain injury may involve osteogenic synthesis of a type I collagen-rich matrix. Procollagen type I N-terminal propeptide (P1NP) reflects type I collagen formation. This single-center retrospective cohort study examined whether baseline P1NP was associated with radiographic NHO within 12 weeks after traumatic brain injury. We reviewed 124 adults transferred to physical and rehabilitation medicine within 21 days after injury who completed 26\u201334 days of inpatient rehabilitation and had 12-week follow-up. The primary Firth penalized logistic regression model included P1NP per 50\u2009ng\/ml, acute care length of stay per 5 days, overall Modified Ashworth Scale score per 5 points, and neutrophil-to-lymphocyte ratio. Twelve-week NHO occurred in 19 (15.3%) patients. Higher P1NP was associated with NHO in the primary model (odds ratio: 6.11, 95% confidence interval: 1.34\u201333.97;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013). Longer acute care length of stay, higher overall Modified Ashworth Scale score, and higher neutrophil-to-lymphocyte ratio were also associated with NHO. In a supplementary model replacing acute care length of stay with the Disability Rating Scale, P1NP did not reach statistical significance (odds ratio: 4.63, 95% confidence interval: 0.85\u201330.18;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.062). In adults with traumatic brain injury undergoing early inpatient rehabilitation, higher baseline P1NP was associated with 12-week NHO in the primary model. Prospective studies with standardized imaging and serial sampling are needed to confirm its predictive value.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/mrr.0000000000000719","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:00:08Z","timestamp":1788508808000},"page":"265-270","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The bone turnover marker procollagen type I N-terminal propeptide is associated with 12-week neurogenic heterotopic ossification after traumatic brain injury"],"prefix":"10.1097","volume":"49","author":[{"given":"Seongmin","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eo Jin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"R1-20261031","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1302\/2046-3758.23.2000152","article-title":"Heterotopic ossification after central nervous system trauma: a current review.","volume":"2","author":"Sullivan","year":"2013","journal-title":"Bone Joint Res"},{"key":"R2-20261031","doi-asserted-by":"crossref","first-page":"689","DOI":"10.5435\/00124635-200911000-00003","article-title":"Heterotopic ossification following traumatic brain injury and spinal cord injury.","volume":"17","author":"Cipriano","year":"2009","journal-title":"J Am Acad Orthop Surg"},{"key":"R3-20261031","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/s41413-020-00119-9","article-title":"Neurological heterotopic ossification: novel mechanisms, prognostic biomarkers and prophylactic therapies.","volume":"8","author":"Wong","year":"2020","journal-title":"Bone Res"},{"key":"R4-20261031","doi-asserted-by":"crossref","first-page":"582","DOI":"10.3349\/ymj.2024.0399","article-title":"Risk factors for heterotopic ossification in traumatic brain injury: an analysis of the Korean national health insurance service data.","volume":"66","author":"Yoon","year":"2025","journal-title":"Yonsei Med J"},{"key":"R5-20261031","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1007\/s00256-016-2441-4","article-title":"MR imaging and ultrasonography findings of early myositis ossificans: a case report.","volume":"45","author":"Lee","year":"2016","journal-title":"Skeletal Radiol"},{"key":"R6-20261031","doi-asserted-by":"crossref","first-page":"807","DOI":"10.3109\/02699052.2013.775490","article-title":"Risk factors for developing heterotopic ossification in patients with traumatic brain injury.","volume":"27","author":"Dizdar","year":"2013","journal-title":"Brain Inj"},{"key":"R7-20261031","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1177\/0269215517723161","article-title":"Occurrence and predictive factors of heterotopic ossification in severe acquired brain injured patients during rehabilitation stay: cross-sectional survey.","volume":"32","author":"Bargellesi","year":"2018","journal-title":"Clin Rehabil"},{"key":"R8-20261031","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1097\/HTR.0b013e3181f78a59","article-title":"Potential risk factors for developing heterotopic ossification in patients with severe traumatic brain injury.","volume":"26","author":"van Kampen","year":"2011","journal-title":"J Head Trauma Rehabil"},{"key":"R9-20261031","first-page":"19","article-title":"Prevalence and risk-factors of neurogenic heterotopic ossification in traumatic spinal cord and traumatic brain injured patients admitted to specialised units in Australia.","volume":"14","author":"Reznik","year":"2014","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"R10-20261031","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jot.2017.10.002","article-title":"Relationship between heterotopic ossification and traumatic brain injury: Why severe traumatic brain injury increases the risk of heterotopic ossification.","volume":"12","author":"Huang","year":"2018","journal-title":"J Orthop Translat"},{"key":"R11-20261031","first-page":"369","article-title":"The pathogenesis of heterotopic ossification after traumatic brain injury. A review of current literature.","volume":"86","author":"Anthonissen","year":"2020","journal-title":"Acta Orthop Belg"},{"key":"R12-20261031","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s00198-010-1501-1","article-title":"Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards.","volume":"22","author":"Vasikaran","year":"2011","journal-title":"Osteoporos Int"},{"key":"R13-20261031","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.1007\/s00198-017-4082-4","article-title":"Use of CTX-I and PINP as bone turnover markers: National Bone Health Alliance recommendations to standardize sample handling and patient preparation to reduce pre-analytical variability.","volume":"28","author":"Szulc","year":"2017","journal-title":"Osteoporos Int"},{"key":"R14-20261031","doi-asserted-by":"crossref","first-page":"19","DOI":"10.11005\/jbm.2019.26.1.19","article-title":"Clinical application of bone turnover markers in osteoporosis in Korea.","volume":"26","author":"Park","year":"2019","journal-title":"J Bone Metab"},{"key":"R15-20261031","doi-asserted-by":"crossref","first-page":"213","DOI":"10.11005\/jbm.2019.26.4.213","article-title":"Position statement on the use of bone turnover markers for osteoporosis treatment.","volume":"26","author":"Park","year":"2019","journal-title":"J Bone Metab"},{"key":"R16-20261031","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ptj\/67.2.206","article-title":"Interrater reliability of a modified Ashworth scale of muscle spasticity.","volume":"67","author":"Bohannon","year":"1987","journal-title":"Phys Ther"},{"key":"R17-20261031","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3233\/NRE-1993-3308","article-title":"Neurogenic heterotopic ossification.","volume":"3","author":"Paul","year":"1993","journal-title":"NeuroRehabilitation"},{"key":"R18-20261031","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1002\/sim.1047","article-title":"A solution to the problem of separation in logistic regression.","volume":"21","author":"Heinze","year":"2002","journal-title":"Stat Med"},{"key":"R19-20261031","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/biomet\/80.1.27","article-title":"Bias reduction of maximum likelihood estimates.","volume":"80","author":"Firth","year":"1993","journal-title":"Biometrika"}],"container-title":["International Journal of Rehabilitation Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MRR.0000000000000719","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:00:54Z","timestamp":1793426454000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MRR.0000000000000719"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/mrr.0000000000000719","relation":{},"ISSN":["0342-5282","1473-5660"],"issn-type":[{"value":"0342-5282","type":"print"},{"value":"1473-5660","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"assertion":[{"value":"2026-06-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}