Evidence map›Paper›PMID 40517892›Full record

ArticleWorld neurosurgery2025

Poor Correlation Between Inflammatory and Brain Injury Biomarkers After Neonatal Intraventricular Hemorrhage: A Pilot Study.

Ankit Agarwal, Miriam Zamorano, Aidan Collier, Braden Oldham, Kaleigh Riggs-Harpur, Thao L Nguyen, David I Sandberg, Stephen A Fletcher, Manish N Shah, Brandon A Miller

Abstract read
In one paragraph

Article in World neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ankit AgarwalPediatrics, The University of Texas Health Science Center at Houston, Houston, Texas, USA. Electronic address: ankit.ag07@gmail.com.
Miriam ZamoranoDepartment of Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA; Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Aidan CollierDepartment of Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Braden OldhamDepartment of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA; Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA.
Kaleigh Riggs-HarpurPediatrics, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Thao L NguyenPediatrics, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
David I SandbergDepartment of Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Stephen A FletcherDepartment of Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Manish N ShahDepartment of Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Brandon A MillerDepartment of Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA; Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA; Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA.

Funding

Reversing Inflammatory Macrophage Activation as Treatment for Neonatal Intraventricular Hemorrhage and HydrocephalusK08NS112580 · NINDS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MILLER, BRANDON A · 2020 to 2025
$885k
NINDS NIH HHS K08 NS112580
6 · The paper itself

Abstract

backgroundThis study investigated changes in hemoglobin and neuroinflammatory and brain injury biomarkers (tumor necrosis factor-alpha [TNF-α] and glial fibrillary acidic protein [GFAP]) in early stages of cerebrospinal fluid (CSF) diversion in preterm neonates with intraventricular hemorrhage (IVH). We hypothesized that patients with higher CSF hemoglobin levels would have higher TNF-α and GFAP levels.

methodsThis prospective study included infants with grade 3 or 4 IVH. All had ventricular reservoirs that were placed following standard neurosurgical care. The first CSF sample was collected on the day of reservoir placement. Subsequent samples were from clinically indicated CSF withdraws to decompress ventricles. Enzyme-linked immunosorbent assays were performed using commercially available kits and standard methods.

resultsEight preterm infants were included in the study. Median postmenstrual age was 26.3 weeks, and median birth weight was 765 g. No biomarkers investigated had a significant correlation with days since reservoir placement. Initially, GFAP and hemoglobin were significantly correlated (Pearson's r = -0.682, P < 0.001), so a linear regression was conducted (slope = -0.00363). However, this relationship was lost when the power of repeated measures analysis was leveraged (repeated measures correlation r = -0.473, P = 0.055, Bonferroni adjusted alpha level = 0.008).

conclusionsThis study found no significant correlation between CSF hemoglobin, TNF-α, and GFAP in the first weeks of CSF diversion in neonates with IVH. There is high variability of these measures, even within subjects. This study reveals the need for further research into neuroinflammatory and brain injury biomarkers in neonates with IVH, their usefulness in clinical decision-making, and long-term outcomes.

Indexed as

Brain InjuriesCerebral HemorrhageCerebral Intraventricular HemorrhageGlial Fibrillary Acidic ProteinTumor Necrosis Factor-alphaBiomarkersFemaleHemoglobinsHumansInfant, NewbornInfant, PrematureMalePilot ProjectsProspective StudiesBiomarkersGFAP protein, humanGlial Fibrillary Acidic ProteinHemoglobinsTumor Necrosis Factor-alphaCerebrospinal fluidGlial fibrillary acidic proteinHemoglobinIntraventricular hemorrhagePretermTumor necrosis factor-alpha

Identifiers

PMID40517892
PMCPMC13277710

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.