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The main aims of our study were (1) to assess the temporal evolution of blood biomarkers of CNS injury and inflammation in individuals with complicated mTBI determined on computer tomography (CT) and magnetic resonance imaging (MRI); (2) to assess the corresponding discriminability of both single- and multi-biomarker panels, from acute to chronic phases after injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with mTBI (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009207), defined as Glasgow Coma Scale score between 13 and 15, loss of consciousness\u2009&lt;\u200930\u00a0min and post-traumatic amnesia\u2009&lt;\u200924\u00a0h, were included. Complicated mTBI \u2013 i.e., presence of any traumatic intracranial injury on neuroimaging \u2013 was present in 8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916) on CT (CT+) and 12% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925) on MRI (MRI+). Blood biomarkers were sampled at four timepoints following injury: admission (within 72\u00a0h), 2 weeks (\u00b1\u20093 days), 3 months (\u00b1\u20092 weeks) and 12 months (\u00b1\u20091 month). CNS biomarkers included were glial fibrillary acidic protein (GFAP), neurofilament light (NFL) and tau, along with 12 inflammation markers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The most discriminative single biomarkers of traumatic intracranial injury were GFAP at admission (CT+:\u00a0AUC\u2009=\u20090.78; MRI+:\u00a0AUC\u2009=\u20090.82), and NFL at 2 weeks (CT+:\u00a0AUC\u2009=\u20090.81; MRI+:\u00a0AUC\u2009=\u20090.89) and 3 months (MRI+:\u00a0AUC\u2009=\u20090.86). MIP-1\u03b2 and IP-10 concentrations were significantly lower across follow-up period in individuals who were CT+\u2009and MRI+. Eotaxin and IL-9 were significantly lower in individuals who were MRI+\u2009only. FGF-basic concentrations increased over time in MRI- individuals and were significantly higher than MRI+\u2009individuals at 3 and 12 months. Multi-biomarker panels improved discriminability over single biomarkers at all timepoints (AUCs\u2009&gt;\u20090.85 for admission and 2-week models classifying CT+\u2009and AUC\u2009\u2248\u20090.90 for admission, 2-week and 3-month models classifying MRI+).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CNS biomarkers GFAP and NFL were useful single diagnostic biomarkers of complicated mTBI, especially in acute and subacute phases after mTBI. Several inflammation markers were suppressed in patients with complicated versus uncomplicated mTBI and remained so even after 12 months. Multi-biomarker panels improved diagnostic accuracy at all timepoints, though at acute and 2-week timepoints, the single biomarkers GFAP and NFL, respectively, displayed similar accuracy compared to multi-biomarker panels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12974-024-03094-8","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T11:01:39Z","timestamp":1714215699000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Chronic immunosuppression across 12 months and high ability of acute and subacute CNS-injury biomarker concentrations to identify individuals with complicated mTBI on acute CT and MRI"],"prefix":"10.1186","volume":"21","author":[{"given":"Gerard Janez Brett","family":"Clarke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turid","family":"Follestad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toril","family":"Skandsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Zetterberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Vik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaj","family":"Blennow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asta Kristine","family":"H\u00e5berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,27]]},"reference":[{"key":"3094_CR1","doi-asserted-by":"publisher","unstructured":"Cassidy JD, Carroll LJ, Peloso PM, et al. 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