Pitt Nursing-Led Study Finds Signature of Pediatric Brain Injury

Researchers at the University of Pittsburgh discovered a promising new biomarker of “complicated” mild- to severe-pediatric traumatic brain injury, or TBI. Unlike a concussion—which usually resolves within weeks—complicated TBI requires at least an overnight hospital stay, signaling a more serious injury.

Led by Pitt Nursing Assistant Professor Lacey Heinsberg, PhD, RN, and co-authored by Senior Associate Dean for Research and Scholarship Yvette Conley, PhD, FAAN, this study is first to identify a signature of potentially reversible chemical modifications of DNA, called epigenetic modifications, that may serve as dynamic indicators of post-injury recovery and guide future precision rehabilitation strategies. Their findings, based on data collected during a longitudinal study at UPMC Children's Hospital of Pittsburgh, were published today in the Journal of Neurotrauma.

“This research brings us closer to understanding how children’s brains respond to injury at the molecular level and how those changes relate to real-world functioning,” said senior author Amery Treble-Barna, PhD, associate professor of physical medicine and rehabilitation, clinical & translational science, and psychology at Pitt School of Medicine. “As a neuropsychologist, I look beyond whether a child can return to school or basic independence. Combining nuanced cognitive and behavioral data with molecular insights allows us to lay the groundwork for personalized care and advance precision rehabilitation in pediatric patients.”

TBI is a leading cause of disability in children, shaped by a complex mix of biological, psychological and social factors. As leaders in neurotrauma research in both children and adults, Pitt and UPMC have long driven innovation in TBI diagnostics and recovery strategies to prevent premature death and reduce disability.

Building on the decades-long legacy of innovation at Pitt’s Safar Center for Resuscitation Research, the new study adds to the growing knowledge about TBI biomarkers in children. In their research, the team focused on modifications of the brain-derived neurotrophic factor (BDNF) gene because of its role in neuroplasticity, which is the brain’s ability to reorganize and heal after injury. Previous studies link BDNF levels to recovery outcomes after TBI in adults, but, until now, no group has looked at its epigenetic modifications in children.

By focusing on one of the most widely studied types of epigenetic modifications—DNA methylation—researchers were able to analyze whether BDNF methylation levels could serve as dynamic biomarkers that reflect both biological and psychosocial factors shaping recovery, offering a unique molecular lens into pediatric TBI.