Evaluation of Serum Prestin as a Potential Biomarker for Trauma Severity in Patients with Traumatic Brain Injury

Objective: Prestin, expressed in cochlear outer hair cells, is essential for auditory signal amplification and may serve as a biomarker for cochlear injury related to trauma. This study aimed to investigate the potential role of prestin in the diagnosis and prognosis of cranial trauma. Methods: A total of 150 participants were included, comprising 110 patients aged 18–70 who were treated for head trauma and 40 age-matched healthy controls. The patients were divided into two groups of 55 each, with Glasgow coma scale (GCS) ≥13 and GCS ≤8, according to the GCS. Prestin was measured by enzyme-linked immunosorbent assay in serum on days 1, 3, and 7 in the patient and also the control groups. In the diagnosis of trauma and determining trauma severity, important risk levels (cut-off values) according to prestin's measurement days were calculated by receiver operating characteristic (ROC) analysis. Results: Prestin values in both the GCS ≥13 and GCS ≤8 groups were dramatically lower than those in the control on all measurement days. Additionally, prestin values in the GCS ≤8 group on days 3 and 7 tended to be lower than those in the GCS ≥13 group. Furthermore, there was a tendency for serum prestin values to increase as time progressed especially in the GCS ≥13 group. ROC analysis showed that prestin values on the first, third, and seventh days showed high accuracy in detecting traumatized individuals with area under the curve (AUC) values of 85%, 81%, and 75%, respectively (sensitivity: 84%, 79%, and 83%, respectively). Also, prestin data on the first day accurately detected the severity of trauma at a high rate (sensitivity, 82%; AUC, 90%). Conclusion: Our findings suggest that serum prestin levels on the first day after trauma may provide supportive information regarding trauma severity. However, further controlled studies are needed before definitive diagnostic or prognostic use. © 2026 The Korean Neurosurgical Society.