Validation and identification of serum biomarkers to predict neurological recovery after acute spinal cord injury

Neurological recovery after acute spinal cord injury is highly variable and therefore difficult to predict. Besides initial injury characteristics, there remains a need for potential objective serum biomarkers that can predict neurological recovery. The main objective of this thesis was to identify such biomarkers. In chapter 2, I aimed to validate serum albumin as a valid biomarker for long-term neurological recovery after acute spinal cord injury. I performed unbiased recursive partitioning (URP) to examine the relationship between neurological outcomes and serum albumin concentration from the Spinal Cord Injury Rehabilitation study. Results showed that serum albumin could be used as a crude prognostic biomarker, particularly in cases where examination for injury characteristics is not complete. In chapter 3, I aimed to identify novel serum biomarkers that can predict long-term neurological recovery after acute spinal cord injury. I performed URP and Factor Analysis to investigate the relationship between neurological recovery and all baseline (i.e., up to 72 hours after injury) serum biomarkers from the Sygen clinical trial. I found that blood factor (including red blood cells, hematocrit, and hemoglobin) is significantly associated with neurological outcomes. However, similarly to results in chapter II, these blood factor markers can only serve as crude prognostic biomarkers, in cases where individuals have incomplete neurological examination. Taken together, these data demonstrate that serum biomarkers, including albumin, red blood cells, hematocrit, and hemoglobin, can predict neurological recovery after acute spinal cord injury. While further research is needed, these biomarkers can be useful for individuals who have incomplete injury characteristics examinations.Education, Faculty ofKinesiology, School ofGraduat