TBI Biomarker Improvements Following Rodent Decompressive Craniectomy and Motor Outcome Validation of Early Cranioplasty

Steffen G Osborn; Daniel C Bartlett; Liu Hong; Matthew A Howard; Mario Zanaty; Marlan R Hansen; Terry C Yin; Brian T Andrews

doi:10.1177/10556656251357992

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TBI Biomarker Improvements Following Rodent Decompressive Craniectomy and Motor Outcome Validation of Early Cranioplasty

Journal article

Peer reviewed

TBI Biomarker Improvements Following Rodent Decompressive Craniectomy and Motor Outcome Validation of Early Cranioplasty

Steffen G Osborn, Daniel C Bartlett, Liu Hong, Matthew A Howard, Mario Zanaty, Marlan R Hansen, Terry C Yin and Brian T Andrews

The Cleft palate-craniofacial journal, Vol.63(7), pp.1968-1973

07/2026

DOI: 10.1177/10556656251357992

PMID: 40660848

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Abstract

BackgroundDecompressive craniectomy (DC) is a venerable clinical tool to manage moderate-to-severe traumatic brain injury (TBI). The utility of recently approved neuroinflammatory biomarkers glial fibrillary acidic protein ( ) and ubiquitin C-terminal hydrolase-L1 ( ) is unclear in DC patients as does the timing of cranioplasty to repair/restore the missing cranial bone. We hypothesize that DC diminishes acute neuroinflammatory biomarkers and and that early cranioplasty improves motor recovery following DC in moderate-to-severe TBI.MethodsA rodent TBI paradigm utilized a "hit-and-run" closed cortical impact to induce moderate-to-severe trauma. GFAP and UCH-L1 were quantified in CD1 mice (ELISA) in sham, TBI, and TBI-DC. Concurrently, Long-Evans rats received early or delayed alloplastic cranioplasty, with beam walk to assess motor proficiency. A 2-way ANOVA with Dunnett's post hoc determined group-level differences.ResultsGFAP and UCH-L1 were elevated in TBI at post-TBI day 1 (GFAP: = .0233; UCH-L1: = .0005) and partially elevated in TBI-DC (GFAP: = .0603; UCH-L1: = .0326). By day 7, biomarker levels converged ( > .05), indicating acute neuroinflammation resolution. Early cranioplasty maintained near-sham motor performance at day 4 ( = .9925). Absence of cranioplasty (TBI-DC) produced persistent deficits (day 4: = .0319; day 11: = .0069; day 18: = .0112). Late cranioplasty yielded improvement, achieving near-sham results by day 11 or post-cranioplasty day 5 ( = .9166).ConclusionsIn this moderate-to-severe TBI model, DC significantly mitigates astroglial and neuronal biomarker expression. Timely cranioplasty further augments motor recovery, underscoring its relevance for optimizing neurological convalescence following decompressive surgery in acute TBI management.

craniofacial surgery

intervention

bone grafting

Details

Title: Subtitle: TBI Biomarker Improvements Following Rodent Decompressive Craniectomy and Motor Outcome Validation of Early Cranioplasty
Creators: Steffen G Osborn - University of Iowa
Daniel C Bartlett - Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Liu Hong - University of Iowa
Matthew A Howard - University of Iowa
Mario Zanaty - University of Iowa
Marlan R Hansen - University of Iowa
Terry C Yin - University of Iowa
Brian T Andrews - University of Iowa
Resource Type: Journal article
Publication Details: The Cleft palate-craniofacial journal, Vol.63(7), pp.1968-1973
DOI: 10.1177/10556656251357992
PMID: 40660848
NLM abbreviation: Cleft Palate Craniofac J
ISSN: 1055-6656
eISSN: 1545-1569
Publisher: SAGE PUBLICATIONS INC
Language: English
Electronic publication date: 07/15/2025
Date published: 07/2026
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Neurology; Molecular Physiology and Biophysics; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Prosthodontics; Craniofacial Anomalies Research Center; Dental Research; Neurosurgery; Otolaryngology
Record Identifier: 9984848120502771

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