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Serum metabolism alteration behind different etiology, diagnosis, and prognosis of disorders of consciousness

中华神经外科杂志(英文) 2024年第03期10卷 199-210页

作者： Ge Qianqian Lu Hezhen Geng Xiaoli Chen Xueling Liu Xiaoyan Sun Haidan Guo Zhengguang Sun Jiameng Qi Feng Niu Xia Wang Aiwei He Jianghong Sun Wei Xu Long Department of Neurosurgery Beijing Tiantan Hospital Capital Medical University Beijing China China-Japan Union Hospital of Jilin University Changchun China Core Instrument Facility Institute of Basic Medical Sciences Chinese Academy of Medical Sciences School of Basic Medicine Peking Union Medical College Beijing China China National Clinical Research Center for Neurological Diseases (NCRC-ND) Beijing China

Background Patients with disorders of consciousness (DoC) exhibit varied revival outcomes based on different etiologies and diagnoses, the mechanisms of which remain largely unknown. The fluctuating clinical presentations in DoC pose challenges in accurately assessing consciousness levels and prognoses, often leading to misdiagnoses. There is an urgent need for a deeper understanding of the physiological changes in DoC and the development of objective diagnostic and prognostic biomarkers to improve treatment *** To explore biomarkers and understand the biological processes, we conducted a comprehensive untargeted metabolomic analysis on serum samples from 48 patients with DoC. Patients were categorized based on etiology (TBI vs. non-TBI), CRS-R scores, and prognosis. Advanced analytical techniques, including PCA and OPLS-DA models, were employed to identify differential *** Our analysis revealed a distinct separation in metabolomic profiles among the different groups. The primary differential metabolites distinguishing patients with varying etiologies were predominantly phospholipids, with a notable decrease in glycerophospholipids observed in the TBI group. Patients with higher CRS-R scores exhibited a pattern of impaired carbohydrate metabolism coupled with enhanced lipid metabolism. Notably, serum concentrations of both LysoPE and PE were reduced in patients with improved outcomes, suggesting their potential as prognostic *** Our study underscores the critical role of phospholipid metabolism in the brain’s metabolic alterations in patients with DoC. It identifies key biomarkers for diagnosis and prognosis, offering insights that could lead to novel therapeutic targets. These findings highlight the value of metabolomic profiling in understanding and potentially treating DoC.

关键词： Disorders of consciousness Serum biomarkers untargeted metabolomic analysis

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