PROSPER: PaediatRic Outcomes and Serum biomarker Panel in acutE traumatic bRain injury/concussion to sever traumatic brain inju
Traumatic brain injury (TBI) is more common in childhood and adolescence than at any other time of life and is one of the most common causes of neurological morbidity and includes concussion. Post concussion syndrome (PCS) combines clinical, cognitive and behavioral symptoms and occurs in one in seven school children sustaining a mTBI for three months or longer and is associated with persistent inflammation. At present there are no evidence-based clinical guidelines or accurate early tests to predict PCS in children.
The PROSPER project aims to
- Perform a retrospective audit of Paediatric Concussion: to evaluate the incidence of paediatric concussion presenting to the ER
- Survey staff attitudes and perceptions of paediatric acute traumatic brain injury
- Prospective study of Biomarkers, neuroimaging and cognitive function on Paediatric traumatic brain injury/concussion
Public Patient Involvement
In response to training needs and clarity of management in cases of traumatic brain injury three separate sets of guidelines were devised:
- Trivial minor head injury guideline;
- Mild Traumatic brain injury /Moderate brain injury guideline incorporating imaging guidelines;
- Concussion mTBI guidelines.
In addition two parent advice leaflets were devised on General Head injury advice incorporating frequently asked questions and Concussion advice.
Severe traumatic brain injury guidelines were devised by the Intensive Care Unit in conjunction with the National Paediatric Neurosurgery Team. These guidelines were reviewed by relevant parties including representatives from the three emergency departments, general paediatrics, neurology, neurosurgery and neurorehabilitation. They were endorsed by the Clinical Guidelines Committee at Children’s Hospital Ireland
Mild-to-severe traumatic brain injury in children: altered cytokines reflect severity. Ryan E, Kelly L, Stacey C, Huggard D, Duff E, McCollum D, Leonard A, Boran G, Doherty DR, Bolger T, Molloy EJ.J Neuroinflammation. 2022 Feb 7;19(1):36. doi: 10.1186/s12974-022-02390-5.PMID: 35130911 Free PMC article.
Traumatic Brain Injury in Children: Glial fibrillary Acidic Protein and Clinical Outcomes. Ryan E, Kelly L, Stacey C, Duff E, Huggard D, Leonard A, Boran G, McCollum D, Doherty D, Bolger T, Molloy EJ.Pediatr Emerg Care. 2022 Mar 1;38(3):e1139-e1142. doi: 10.1097/PEC.0000000000002527.PMID: 34469402
Altered distributions and functions of natural killer T cells and γδ T cells in neonates with neonatal encephalopathy, in school-age children at follow-up, and in children with cerebral palsy. Taher NAB, Kelly LA, Al-Harbi AI, O’Dea MI, Zareen Z, Ryan E, Molloy EJ, Doherty DG.J Neuroimmunol. 2021 Jul 15;356:577597. doi: 10.1016/j.jneuroim.2021.577597. Epub 2021 Apr 29.PMID: 33964735 Free article.
Altered Toll-Like Receptor Signalling in Children with Down Syndrome. Huggard D, Koay WJ, Kelly L, McGrane F, Ryan E, Lagan N, Roche E, Balfe J, Leahy TR, Franklin O, Moreno-Oliveira A, Melo AM, Doherty DG, Molloy EJ.Mediators Inflamm. 2019 Sep 12;2019:4068734. doi: 10.1155/2019/4068734. eCollection 2019.PMID: 31611734 Free PMC article.
Increased systemic inflammation in children with Down syndrome. Huggard D, Kelly L, Ryan E, McGrane F, Lagan N, Roche E, Balfe J, Leahy TR, Franklin O, Doherty DG, Molloy EJ.Cytokine. 2020 Mar;127:154938. doi: 10.1016/j.cyto.2019.154938. Epub 2019 Nov 27.PMID: 31785499