Metabolomics Analysis Reveals Potential Biomarkers for Diffuse Axonal Injury

Background Metabolism is essential for life maintenance, neurological function and injury repair, yet its role in diffuse axonal injury (DAI) is not fully understood. Methods 30 DAI patients and 34 non-DAI patients were recruited based on the classification criteria using Magnetic Resonance Imaging (MRI) within 30 days of admission in this exploratory research. Serum samples and clinical parameters were collected upon admission, with the Glasgow Outcome Scale Extended (GOSE) at 6 months post-injury used as the neurological functional outcome. The metabolome was assayed using liquid chromatography-mass spectrometry. Results The DAI group and non-DAI group showed significant differences in pupillary light reflex, Glasgow Coma Scale (GCS) score, and Marshall computed tomography (CT) score, as well as in the expression levels of 27 metabolites in serum. Random forest analysis indicated that Lysophosphatidylcholine (LPC) 22:3 sn-2 and carnitine C8:1 greatly contributed to distinguishing DAI patients from non-DAI patients (MeanDecreaseGini: 3.81, 5.16). The combined prediction of DAI using these two metabolites yielded an area under the curve (AUC) of 0.944, which was higher than the combination of clinical parameters. Conclusions The serum metabolomics revealed potential biomarkers for DAI and has significant value for exploring pathogenesis, determining early diagnosis, and improving long-term neurological function.