Diagnosing a patient with a concussion is often based solely on a doctor’s evaluation and the presence of classic symptoms, such as headache, confusion, lack of coordination, memory loss, nausea, vomiting, dizziness, tinnitus and excessive sleepiness. Sometimes, however, these symptoms don’t emerge until several days after the injury. That means patients may be unaware of how serious their injury is and get right back into the game—only to risk subsequent injury that may lead to permanent brain damage.
But researchers say they’ve developed a potential way to diagnose concussion earlier and with much less guesswork. A group of scientists have formulated a simple blood test that detects evidence of concussion nearly right away, allowing physicians to start the correct treatment plan at a critical point in the injury before damage that has occurred is irreversible. The findings were published March 28 in JAMA Neurology.
“This could ultimately change the way we diagnose concussions, not only in children, but in anyone who sustains a head injury,” Dr. Linda Papa, an emergency medicine physician at Orlando Health and lead author of the study, said in a press statement. “We have so many diagnostic blood tests for different parts of the body, like the heart, liver and kidneys, but there’s never been a reliable blood test to identify trauma in the brain. We think this test could change that.”
The new test detects a biomarker in the blood called glial fibrillary acidic protein (GFAP). These proteins surround neurons in the brain and are released when a head injury occurs. In order for GFAPs to be present in a blood test, they need to pass the brain-blood barrier; the protein will enter the bloodstream only as a result of serious head injury. The researchers found that these proteins were present in the blood of concussion patients, and they were detectable for up to a week after the injury was sustained.
To conduct this analysis, the researchers looked at medical records of 600 patients over three years. They cross-referenced results from brain scans with blood tests. By detecting the presence of this protein in the blood, the researchers were able to accurately identify mild to moderate traumatic brain lesions 97 percent of the time.
The blood test could also help to cut down costs in concussion diagnosis. When physicians suspect a patient has a concussion, they usually order a CT scan to help identify the presence of lesions in the brain. But these tests are costly and sometimes unnecessarily expose a patient to radiation. Radiation is linked to some cancers, so it’s best to keep exposure to a minimum, especially for young children.
A previous study conducted by the same group of researchers looked at how effective the blood test is for diagnosing head injuries in kids. For that study, the researchers analyzed blood test results for 152 children within six hours after they sustained head injuries. They found the test was 94 percent effective in this young cohort. Unlike adults, young kids often aren’t able to articulate their symptoms, which means a physician may not diagnose them early enough.
According to the U.S. Centers for Disease Control and Prevention, an estimated 1.7 million people sustain traumatic brain injury each year, and approximately 75 percent of those injuries are clinically categorized as concussions with various degrees of severity. The American Academy of Pediatrics estimates that children under 14 make some 500,000 emergency room visits annually for traumatic brain injury. Most deaths that occur from concussion are associated with “second impact syndrome” incidents, which are essentially when someone suffers a head injury, returns to a sport without proper rest or treatment, and then is injured again.
Source: A Simple Blood Test Could Detect Concussion Almost Right Away
REUTERS/MIKE BLAKE