# Blood-Biomarkers and Risk Factors of Acute Brain Injury associated with Neurodisability in Ugandan Children [BRAIN-Child]

> **NIH NIH R21** · INDIANA UNIVERSITY INDIANAPOLIS · 2022 · $176,845

## Abstract

ABSTRACT
Neurocognitive impairment (NCI) is a common complication of acute brain injury in two unrelated nervous system
disorders: cerebral malaria (CM) and traumatic brain injury (TBI). In children ages 5–15 years, six of the top 15
causes of mortality and disability are injury-related, and 95% of these occur in low- and middle- income countries
(LMICs). The burden of TBI in LMICs is not fully known but is estimated at three times more than in high-income
countries. Meanwhile, the high burden of pediatric CM is borne almost exclusively by African nations. Thus, there
is a global need for reliable, noninvasive prognostic tools that can predict the risk of future NCI as early as
possible after acute brain injury. Biomarkers of brain injury—proteins expressed in the brain parenchyma (by
neurons and astrocytes)—can be useful prognostic tools in brain injury. Neuronal injury markers tau and UCH-
L1, and astrocyte injury marker GFAP can predict NCI after moderate/severe TBI; likewise, tau and UCH-L1 are
elevated in CM and predict future NCI. Further, the pathophysiologies of CM and TBI have overlapping features:
injury to the brain’s microvasculature leads to hypoxia/ischemia with glucose abnormalities, cellular injury, and
endothelial dysfunction. These effects interact to complicate acute brain injury resulting in impaired cognitive
functions. Our group has led studies identifying biomarkers and risk factors of pediatric CM in an LMIC setting,
but no such research has been conducted for pediatric TBI to understand brain injury in children at risk of NCI
after TBI. To address this gap in knowledge, we propose a study to: (1) screen a specific set of blood biomarkers
implicated in NCI after CM for their roles in NCI after TBI in Uganda and (2) build on the successful work on CM
and NCI by members of our research team within Global Health Uganda and Makerere University, expanding
infrastructure and personnel to conduct research on NCI after TBI. We hypothesize that blood biomarkers of
acute brain injury and risk factors including glucose abnormalities, cellular injury, and endothelial dysfunction
may help identify children at risk of NCI after acute TBI. Our research and collaboration aims are as follows:
Research aim 1 will determine if biomarkers and risk factors of brain injury elevated in pediatric CM are elevated
in pediatric TBI. We will determine if children with moderate/severe TBI (N=80) have elevated biomarkers
compared to mild TBI (N=120) or controls (N=100) and if the biomarkers are associated with known risk factors
of brain injury. Aim 2 will determine if elevated brain injury biomarkers in pediatric TBI correlate with NCI at 6-
month follow-up, to be assessed using: (1) K-ABC for overall cognition and working memory, (2) TOVA for
attention, and (3) BNIS-C for cognitive function screening. Our capacity building aim will expand capacity for
interdisciplinary NCI research in Uganda by supporting training in neuropsychological methods that a...

## Key facts

- **NIH application ID:** 10538862
- **Project number:** 1R21NS129234-01
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Paul Bangirana
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $176,845
- **Award type:** 1
- **Project period:** 2022-08-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10538862

## Citation

> US National Institutes of Health, RePORTER application 10538862, Blood-Biomarkers and Risk Factors of Acute Brain Injury associated with Neurodisability in Ugandan Children [BRAIN-Child] (1R21NS129234-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10538862. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*