In her doctoral thesis, Emma Andersson investigates whether early biomarkers can provide insight into the short- and long-term consequences of severe traumatic brain injuries.

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Emma Andersson: Biomarkers may improve assessment of severe brain injuries

Published

28 January 2025

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Severe traumatic brain injuries often lead to lasting disabilities or even death. Emma Andersson has investigated how biomarkers can be used to offer an earlier and clearer picture of the consequences of brain injuries, both in the short and long term.

Emma Andersson is a doctoral student at the Institute of Clinical Sciences and is completing her residency in anesthesiology and intensive care at Sahlgrenska University Hospital.

EMMA ANDERSSON
Dissertation defense: 21 February 2025 (click for details)
Doctoral thesis: Biomarkers in relation to outcome after severe traumatic brain injury and severe covid-19
Research area: Anesthesiology and Intensive Care
Sahlgrenska Academy, The Institute of Clinical Sciences

Traumatic brain injuries can be difficult to evaluate, especially in unconscious or sedated patients. Current methods depend on clinical assessments of consciousness levels and radiological imaging.

Emma Andersson’s doctoral thesis explores whether biomarker analysis could complement these evaluations. These biomarkers are specific proteins released into the blood or cerebrospinal fluid when brain cells are damaged.

Figure from the thesis. GFAP, NfL, and Tau are three proteins found in different types of brain cells. These proteins are released into the blood or cerebrospinal fluid when brain cells are damaged.

Predicting long-term outcomes

What do the studies reveal about biomarkers?
“Our results show that the biomarkers NfL, Tau, and GFAP, analyzed within the first two weeks after a severe brain injury, are associated with the patient’s level of independence both one year and 10–15 years after the injury. About half of the patients either die or are unable to regain independence a year after the injury. Our studies show the potential of these markers to reflect the extent of the injury and its consequences, both short and long term,” says Emma Andersson, who is completing her residency in anesthesiology and intensive care at Sahlgrenska University Hospital.

Figure from the thesis. Overview of pathophysiological mechanisms from traumatic brain injury. ATP: Adenosine triphosphate, ADP: Adenosine diphosphate, Ca2+: Calcium, K+: Potassium, Na+: Sodium, ROS: Reactive oxygen species, TCA: Tricarboxylic acid cycle.

Studying Covid-19 patients

The thesis also shows that half of the patients who received intensive care for severe Covid-19 had impaired cognitive function afterward.

“There are indications that the biomarkers NfL and GFAP are related to cognitive function in these patients. However, age is the factor that most strongly impacts cognitive outcomes.”

What have been the most rewarding and challenging parts of the doctoral project?
“The most rewarding part has been talking to the people who participated in the studies and having the privilege of hearing their life stories. The most challenging aspect has been limiting both myself and the scope of the studies.”

Text: Jakob Lundberg

Area

Health and medicine