• Eric Mercier, Pier-Alexandre Tardif, Peter A Cameron, Marcel Émond, Lynne Moore, Biswadev Mitra, Marie-Christine Ouellet, Jérôme Frenette, Elaine de Guise, and Natalie Le Sage.
• a Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , Canada.
• Brain Inj. 2018 Jan 1; 32 (1): 29-40.

BackgroundThis systematic review aimed to determine the prognostic value of neuron-specific enolase (NSE) to predict post-concussion symptoms following mild traumatic brain injury (TBI).MethodsSeven databases were searched for studies evaluating the association between NSE levels and post-concussion symptoms assessed ≥ 3 months (persistent) or ≥ 7 days < 3 months (early) after mild TBI. Two researchers independently screened studies for inclusion, extracted data and appraised quality using the Quality in Prognostic Studies (QUIPS) tool.ResultsThe search strategy yielded a total of 23,298 citations from which 8 cohorts presented in 10 studies were included. Studies included between 45 and 141 patients (total 608 patients). The outcomes most frequently assessed were post-concussion syndrome (PCS, 12 assessments) and neuropsychological performance deficits (10 assessments). No association was found between an elevated NSE serum level and PCS. Only one study reported a statistically significant association between a higher NSE serum level and alteration of at least three cognitive domains at 2 weeks but this association was no longer significant at 6 weeks. Overall, risk of bias of the included studies was considered moderate.ConclusionsEarly NSE serum level is not a strong independent predictor of post-concussion symptoms following mild TBI.

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