For decades, the gold standard for diagnosing concussions was noting symptoms—loss of consciousness, dizziness, and disorientation—and performing CT scans to check for obvious signs of physical damage. But if a Florida-area emergency room physician is correct, that diagnosis procedure may soon include blood tests.
In a study published earlier this week in JAMA Neurology, lead researcher Linda Papa presented the results of nearly 600 examinations conducted in an Orlando medical facility from March 2010 to March 2014. About half of the subjects were suffering from concussion or concussion symptoms; others were being treated for ailments unrelated to the brain. Papa and her team took blood at regular intervals from each group for seven days to measure levels of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1), two proteins that are believed to enter the blood after cranial trauma. The researchers found that elevated levels of the proteins were predictive of mild to moderate traumatic brain injury, traumatic intracranial lesions, and neurosurgical interventions. While UCH-L1 peaked in first couple of days after a head injury, GFAP was an effective indicator of a brain trauma—or a medical response—for a full week.
Because signs of concussion are not always present on radiographic imaging, having a defined marker for injury to the brain could one day contribute to keeping concussed athletes out of action until they heal. Papa is consulting with Banyan Biomarkers, Inc., a medical device company, on a portable station that could check for the proteins on the spot. Doing so could lead to earlier diagnoses that might prevent patients from sustaining any further trauma. For children, the blood test diagnostic could help limit the use of CTA scans and therefore avoid radiation exposure.