Phenotyping the Spectrum of Traumatic Brain Injury: A Review and Pathway to Standardization.

Journal: Journal of neurotrauma
Published Date: Jun 10, 2021

Abstract

It is widely appreciated that the spectrum of traumatic brain injury (TBI), mild through severe, contains distinct clinical presentations, variably referred to as subtypes, phenotypes, and/or clinical profiles. As part of the Brain Trauma Blueprint TBI State of the Science, we review the current literature on TBI phenotyping with an emphasis on unsupervised methodological approaches, and describe five phenotypes that appear similar across reports. However, we also find the literature contains divergent analysis strategies, inclusion criteria, findings, and use of terms. Further, whereas some studies delineate phenotypes within a specific severity of TBI, others derive phenotypes across the full spectrum of severity. Together, these facts confound direct synthesis of the findings. To overcome this, we introduce PhenoBench, a freely available code repository for the standardization and evaluation of raw phenotyping data. With this review and toolset, we provide a pathway toward robust, data-driven phenotypes that can capture the heterogeneity of TBI, enabling reproducible insights and targeted care.

Authors

  • Mary Jo Pugh
    VA Salt Lake City Health Care System, Salt Lake City, UT, United States of America.
  • Eamonn Kennedy
    Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City, Salt Lake City, Utah, USA.
  • Eric M Prager
    Cohen Veterans Bioscience, New York, New York, USA.
  • Jeffrey Humpherys
    Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City, Salt Lake City, Utah, USA.
  • Kristen Dams-O'Connor
    Department of Rehabilitation and Human Performance, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Dallas Hack
    Cohen Veterans Bioscience, New York, New York, USA.
  • Mary Katherine McCafferty
    Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City, Salt Lake City, Utah, USA.
  • Jessica Wolfe
    Cohen Veterans Bioscience, New York, New York, USA.
  • Kristine Yaffe
    Departments of Neurology, Psychiatry and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
  • Michael McCrea
    Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Adam R Ferguson
    Brain and Spinal Injury Center (BASIC), Department of Neurological Surgery, University of California, San Francisco; San Francisco Veterans Affairs Medical Center, San Francisco, CA 94143.
  • Lee Lancashire
    Cohen Veterans Bioscience, New York, New York, USA.
  • Jamshid Ghajar
    Brain Trauma Foundation, Palo Alto, CA 94301, USA.
  • Angela Lumba-Brown
    Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA.

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