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Advances in Multimodality Monitoring in Traumatic Brain Injury.

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Τίτλος: Advances in Multimodality Monitoring in Traumatic Brain Injury.
Συγγραφείς: Moberg D; Moberg Analytics, Inc, 109 S. 13th St., Unit 2-South, Philadelphia, PA, 19107, USA. dick@moberganalytics.com., Moyer EJ; Moberg Analytics, Inc, 109 S. 13th St., Unit 2-South, Philadelphia, PA, 19107, USA., Kamar F; Department of Medical Biophysics, Western University, London, Canada., Maddux C; Moberg Analytics, Inc, 109 S. 13th St., Unit 2-South, Philadelphia, PA, 19107, USA.
Πηγή: Current neurology and neuroscience reports [Curr Neurol Neurosci Rep] 2026 Sep 14; Vol. 26 (1). Date of Electronic Publication: 2026 Sep 14.
Τύπος έκδοσης: Journal Article; Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Current Science Inc Country of Publication: United States NLM ID: 100931790 Publication Model: Electronic Cited Medium: Internet ISSN: 1534-6293 (Electronic) Linking ISSN: 15284042 NLM ISO Abbreviation: Curr Neurol Neurosci Rep Subsets: MEDLINE
Imprint Name(s): Original Publication: Philadelphia, PA : Current Science Inc., c2001-
Ιατρικοί όροι (MeSH): Brain Injuries, Traumatic*/physiopathology , Brain Injuries, Traumatic*/diagnosis , Brain Injuries, Traumatic*/therapy , Neurophysiological Monitoring*/methods, Monitoring, Physiologic/methods ; Intracranial Pressure/physiology ; Humans ; Electroencephalography
Περίληψη: Purpose of Review: Multimodal monitoring (MMM) has the potential to transform the management of secondary brain injury following traumatic brain injury (TBI) to enable more personalized care. Despite its promise, the optimal combination of monitoring modalities and the interpretation of complex data streams remain insufficiently mature for MMM to be considered standard of care. This review evaluates the current state of MMM technologies, their clinical applications, and their emerging role in improving TBI management and guiding the path toward broader clinical adoption. This review focuses on real-time physiological data streams that can provide management guidance in a time frame commensurate with the onset of sudden events such as seizures, brain hypoxic events, and excursions of cerebral hypertension. Thus, we do not cover more static modalities such as imaging and biomarkers.
Recent Findings: Recent studies highlight the potential of MMM to reduce variability in TBI outcomes associated with secondary insults. Integration of physiological variables-such as intracranial pressure, brain tissue oxygenation, arterial blood pressure, and electroencephalography-combined with artificial intelligence (AI) and advanced analytics, may enable earlier detection and prediction of adverse events. However, key challenges remain, including the need for larger harmonized datasets, standardized acquisition and interpretation methods, and prospective validation of multimodal-guided interventions. MMM is emerging as a cornerstone technology to enhance patient phenotyping in TBI, enabling more individualized and timely therapeutic interventions. Continued advances in data integration, analytics, and standardization will be essential to translate MMM from a promising research tool into a validated component of precision neurocritical care.
(© 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Competing Interests: Declarations. Competing interests: Dick Moberg, Ethan Moyer, and Craig Maddux are employees of Moberg Analytics Human and Animal Rights and Informed Consent: No animal or human subjects were used in this study.
References: Front Neurol. 2021 Sep 07;12:729184. (PMID: 34557154)
J Neurotrauma. 2021 Oct 15;38(20):2790-2800. (PMID: 34407385)
Aust Crit Care. 2025 Mar;38(2):101138. (PMID: 39550335)
J Neurosurg. 2022 Nov 11;139(1):184-193. (PMID: 36683191)
BMJ Open. 2019 Sep 20;9(9):e030727. (PMID: 31542757)
Neurosurgery. 2025 Apr 3;97(4):863-872. (PMID: 40178267)
Neurotherapeutics. 2023 Oct;20(6):1457-1471. (PMID: 37491682)
J Appl Physiol (1985). 2025 Jun 1;138(6):1361-1371. (PMID: 40234388)
Neurocrit Care. 2023 Jun;38(3):781-790. (PMID: 36922475)
J Cereb Blood Flow Metab. 2019 Aug;39(8):1469-1485. (PMID: 31088234)
Front Physiol. 2022 Dec 01;13:1071161. (PMID: 36531179)
Neurocrit Care. 2025 Jun;42(3):1074-1086. (PMID: 39562386)
Stroke. 2002 Dec;33(12):2738-43. (PMID: 12468763)
Neurophotonics. 2022 Jul;9(3):035001. (PMID: 35874144)
Intensive Care Med. 2022 Jun;48(6):649-666. (PMID: 35595999)
Crit Care. 2025 May 21;29(1):207. (PMID: 40399968)
Neurocrit Care. 2024 Oct;41(2):330-331. (PMID: 38570411)
Curr Opin Crit Care. 2025 Apr 01;31(2):155-161. (PMID: 39808443)
Neurocrit Care. 2022 Aug;37(Suppl 2):202-205. (PMID: 35641807)
J Crit Care. 2024 Aug;82:154806. (PMID: 38555684)
Brain Sci. 2025 Oct 29;15(11):. (PMID: 41300168)
Lancet Neurol. 2024 Jan;23(1):7-9. (PMID: 37977158)
Lancet Neurol. 2024 Jan;23(1):71-80. (PMID: 37977157)
Front Hum Neurosci. 2025 Nov 05;19:1682584. (PMID: 41268147)
Ann Biomed Eng. 2019 Mar;47(3):714-730. (PMID: 30607645)
Biomed Opt Express. 2023 May 02;14(6):2432-2448. (PMID: 37342705)
J Neurosci Nurs. 2017 Apr;49(2):85-89. (PMID: 28277450)
Acta Neurochir (Wien). 2022 Dec;164(12):3091-3100. (PMID: 36260235)
Crit Care. 2020 May 26;24(1):266. (PMID: 32456684)
Sci Rep. 2025 Jan 2;15(1):95. (PMID: 39747195)
Intensive Care Med. 2025 Jun;51(6):1112-1127. (PMID: 40522481)
Crit Care. 2024 Dec 20;28(1):427. (PMID: 39707556)
JAMA Neurol. 2020 Apr 1;77(4):489-499. (PMID: 31886870)
J Cereb Blood Flow Metab. 2020 Nov;40(11):2304-2314. (PMID: 31775565)
J Neurotrauma. 2020 Jan 15;37(2):389-396. (PMID: 31583962)
Crit Care Med. 2023 Dec 1;51(12):1740-1753. (PMID: 37607072)
Neurocrit Care. 2025 Jun;42(3):937-944. (PMID: 39623160)
J Neurotrauma. 2024 Jan;41(1-2):271-291. (PMID: 37742105)
Contributed Indexing: Keywords: Multimodal Monitoring; Neurocritical Care; Neuromonitoring; Traumatic Brain Injury
Entry Date(s): Date Created: 20260914 Date Completed: 20260914 Latest Revision: 20261008
Update Code: 20261008
DOI: 10.1007/s11910-026-01518-x
PMID: 42734883
Βάση Δεδομένων: MEDLINE
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  Data: Purpose of Review: Multimodal monitoring (MMM) has the potential to transform the management of secondary brain injury following traumatic brain injury (TBI) to enable more personalized care. Despite its promise, the optimal combination of monitoring modalities and the interpretation of complex data streams remain insufficiently mature for MMM to be considered standard of care. This review evaluates the current state of MMM technologies, their clinical applications, and their emerging role in improving TBI management and guiding the path toward broader clinical adoption. This review focuses on real-time physiological data streams that can provide management guidance in a time frame commensurate with the onset of sudden events such as seizures, brain hypoxic events, and excursions of cerebral hypertension. Thus, we do not cover more static modalities such as imaging and biomarkers.<br />Recent Findings: Recent studies highlight the potential of MMM to reduce variability in TBI outcomes associated with secondary insults. Integration of physiological variables-such as intracranial pressure, brain tissue oxygenation, arterial blood pressure, and electroencephalography-combined with artificial intelligence (AI) and advanced analytics, may enable earlier detection and prediction of adverse events. However, key challenges remain, including the need for larger harmonized datasets, standardized acquisition and interpretation methods, and prospective validation of multimodal-guided interventions. MMM is emerging as a cornerstone technology to enhance patient phenotyping in TBI, enabling more individualized and timely therapeutic interventions. Continued advances in data integration, analytics, and standardization will be essential to translate MMM from a promising research tool into a validated component of precision neurocritical care.<br /> (© 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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  Data: Declarations. Competing interests: Dick Moberg, Ethan Moyer, and Craig Maddux are employees of Moberg Analytics Human and Animal Rights and Informed Consent: No animal or human subjects were used in this study.
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  Data: Front Neurol. 2021 Sep 07;12:729184. (PMID: <searchLink fieldCode="PM" term="%2234557154%22">34557154)</searchLink><br />J Neurotrauma. 2021 Oct 15;38(20):2790-2800. (PMID: <searchLink fieldCode="PM" term="%2234407385%22">34407385)</searchLink><br />Aust Crit Care. 2025 Mar;38(2):101138. (PMID: <searchLink fieldCode="PM" term="%2239550335%22">39550335)</searchLink><br />J Neurosurg. 2022 Nov 11;139(1):184-193. (PMID: <searchLink fieldCode="PM" term="%2236683191%22">36683191)</searchLink><br />BMJ Open. 2019 Sep 20;9(9):e030727. (PMID: <searchLink fieldCode="PM" term="%2231542757%22">31542757)</searchLink><br />Neurosurgery. 2025 Apr 3;97(4):863-872. (PMID: <searchLink fieldCode="PM" term="%2240178267%22">40178267)</searchLink><br />Neurotherapeutics. 2023 Oct;20(6):1457-1471. (PMID: <searchLink fieldCode="PM" term="%2237491682%22">37491682)</searchLink><br />J Appl Physiol (1985). 2025 Jun 1;138(6):1361-1371. (PMID: <searchLink fieldCode="PM" term="%2240234388%22">40234388)</searchLink><br />Neurocrit Care. 2023 Jun;38(3):781-790. (PMID: <searchLink fieldCode="PM" term="%2236922475%22">36922475)</searchLink><br />J Cereb Blood Flow Metab. 2019 Aug;39(8):1469-1485. (PMID: <searchLink fieldCode="PM" term="%2231088234%22">31088234)</searchLink><br />Front Physiol. 2022 Dec 01;13:1071161. (PMID: <searchLink fieldCode="PM" term="%2236531179%22">36531179)</searchLink><br />Neurocrit Care. 2025 Jun;42(3):1074-1086. (PMID: <searchLink fieldCode="PM" term="%2239562386%22">39562386)</searchLink><br />Stroke. 2002 Dec;33(12):2738-43. (PMID: <searchLink fieldCode="PM" term="%2212468763%22">12468763)</searchLink><br />Neurophotonics. 2022 Jul;9(3):035001. (PMID: <searchLink fieldCode="PM" term="%2235874144%22">35874144)</searchLink><br />Intensive Care Med. 2022 Jun;48(6):649-666. (PMID: <searchLink fieldCode="PM" term="%2235595999%22">35595999)</searchLink><br />Crit Care. 2025 May 21;29(1):207. (PMID: <searchLink fieldCode="PM" term="%2240399968%22">40399968)</searchLink><br />Neurocrit Care. 2024 Oct;41(2):330-331. (PMID: <searchLink fieldCode="PM" term="%2238570411%22">38570411)</searchLink><br />Curr Opin Crit Care. 2025 Apr 01;31(2):155-161. (PMID: <searchLink fieldCode="PM" term="%2239808443%22">39808443)</searchLink><br />Neurocrit Care. 2022 Aug;37(Suppl 2):202-205. (PMID: <searchLink fieldCode="PM" term="%2235641807%22">35641807)</searchLink><br />J Crit Care. 2024 Aug;82:154806. (PMID: <searchLink fieldCode="PM" term="%2238555684%22">38555684)</searchLink><br />Brain Sci. 2025 Oct 29;15(11):. (PMID: <searchLink fieldCode="PM" term="%2241300168%22">41300168)</searchLink><br />Lancet Neurol. 2024 Jan;23(1):7-9. (PMID: <searchLink fieldCode="PM" term="%2237977158%22">37977158)</searchLink><br />Lancet Neurol. 2024 Jan;23(1):71-80. (PMID: <searchLink fieldCode="PM" term="%2237977157%22">37977157)</searchLink><br />Front Hum Neurosci. 2025 Nov 05;19:1682584. (PMID: <searchLink fieldCode="PM" term="%2241268147%22">41268147)</searchLink><br />Ann Biomed Eng. 2019 Mar;47(3):714-730. (PMID: <searchLink fieldCode="PM" term="%2230607645%22">30607645)</searchLink><br />Biomed Opt Express. 2023 May 02;14(6):2432-2448. (PMID: <searchLink fieldCode="PM" term="%2237342705%22">37342705)</searchLink><br />J Neurosci Nurs. 2017 Apr;49(2):85-89. (PMID: <searchLink fieldCode="PM" term="%2228277450%22">28277450)</searchLink><br />Acta Neurochir (Wien). 2022 Dec;164(12):3091-3100. (PMID: <searchLink fieldCode="PM" term="%2236260235%22">36260235)</searchLink><br />Crit Care. 2020 May 26;24(1):266. (PMID: <searchLink fieldCode="PM" term="%2232456684%22">32456684)</searchLink><br />Sci Rep. 2025 Jan 2;15(1):95. (PMID: <searchLink fieldCode="PM" term="%2239747195%22">39747195)</searchLink><br />Intensive Care Med. 2025 Jun;51(6):1112-1127. (PMID: <searchLink fieldCode="PM" term="%2240522481%22">40522481)</searchLink><br />Crit Care. 2024 Dec 20;28(1):427. (PMID: <searchLink fieldCode="PM" term="%2239707556%22">39707556)</searchLink><br />JAMA Neurol. 2020 Apr 1;77(4):489-499. (PMID: <searchLink fieldCode="PM" term="%2231886870%22">31886870)</searchLink><br />J Cereb Blood Flow Metab. 2020 Nov;40(11):2304-2314. (PMID: <searchLink fieldCode="PM" term="%2231775565%22">31775565)</searchLink><br />J Neurotrauma. 2020 Jan 15;37(2):389-396. (PMID: <searchLink fieldCode="PM" term="%2231583962%22">31583962)</searchLink><br />Crit Care Med. 2023 Dec 1;51(12):1740-1753. (PMID: <searchLink fieldCode="PM" term="%2237607072%22">37607072)</searchLink><br />Neurocrit Care. 2025 Jun;42(3):937-944. (PMID: <searchLink fieldCode="PM" term="%2239623160%22">39623160)</searchLink><br />J Neurotrauma. 2024 Jan;41(1-2):271-291. (PMID: <searchLink fieldCode="PM" term="%2237742105%22">37742105)</searchLink>
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