A new blood test developed by researchers at Monash University could revolutionize the diagnosis and management of concussions, also known as mild traumatic brain injuries (mTBI). By measuring the blood levels of three specific biomarkers within six hours of the injury, the test can accurately determine whether someone has suffered a concussion.
Currently, diagnosing concussions is challenging because the signs and symptoms can be subtle, with no obvious observable injury. Brain imaging often cannot detect the condition unless there has been bleeding in the brain. Clinicians rely on subjective observations of physical signs and self-reported symptoms, neither of which are specific to concussion. This often results in individuals being discharged from the emergency department without a definitive diagnosis.
The researchers discovered that measuring the levels of three proteins – interleukin-6 (IL-6), glial fibrillary acidic protein (GFAP), and ubiquitin C-terminal hydrolase-L1 (UCH-L1) – in the blood can accurately diagnose concussion in individuals under 50 years old who visited the emergency department within six hours of the injury.
In the study, 118 participants were enrolled, with 74 having mTBI and 44 being uninjured controls. The concussed patients reported the duration of memory loss immediately after the injury and were tested for intellectual functioning, memory performance, and speed. Blood samples were taken within six hours and seven days after the injury to test the plasma levels of IL-6, GFAP, and UCH-L1.
The researchers used software to determine the accuracy of each biomarker. They found that GFAP levels before six hours showed good accuracy in distinguishing mTBI from controls, even in participants without loss of consciousness or post-traumatic amnesia. UCH-L1 had moderate accuracy for distinguishing mTBI from controls within six hours and good accuracy after seven days. IL-6 showed excellent utility for distinguishing mTBI from controls within six hours and after seven days, but only in female participants and those with loss of consciousness/post-traumatic amnesia.
The combination of IL-6, GFAP, and UCH-L1 showed incredible sensitivity and specificity in distinguishing patients with a concussion from those without. The blood test could be beneficial in providing certainty in difficult-to-assess cases within the emergency department and could be particularly useful in situations where a patient may be unable to communicate their symptoms, such as cases of domestic violence.
In the context of sports-related concussions, the test could enable earlier management of the condition. While it may not be feasible to conduct a test that alters decisions within a match, players with a potential or suspected concussion could be tested soon after the match, aiding in their recovery and return-to-play process.
In addition to the three biomarkers identified, the researchers found that another biomarker, neurofilament light (NfL), was elevated in the blood a week after the concussion and had similar diagnostic properties. This could be useful when individuals consult a general practitioner days after an impact, especially in situations where diagnostic certainty is crucial for safe return-to-work or return-to-play decisions, such as in military or sports settings.
Overall, this new blood test shows promise in improving the accuracy and efficiency of diagnosing and managing concussions. Further research and validation are needed to fully establish its clinical utility.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
