Recently, growing evidence that concussions may have more lasting and serious effects has brought awareness to the dangers of head injuries and has prompted scientists to look for ways to detect and diagnose such injuries so that the patients receive proper treatment and the effects of the trauma are minimized.
A study published in JAMA Neurology, led by Dr. Linda Papa, director of clinical research and emergency physician at Orlando Regional Medical Center represents a breakthrough in the field. It reports on a promising blood test that could distinguish the more serious cases of TBI that require further evaluation. The research team focused on two blood proteins that have already been linked to brain injuries and then expanded on that work by studying how levels of these two proteins, or biomarkers, change immediately after head trauma.
The team collected blood from 584 people coming to the Orlando Regional Medical Center, a Level 1 Trauma Center for trauma-related injuries. About half them had brain-related injuries, and half had other traumas, including broken bones and chest injuries. Papa wanted to test several things about the blood test, including whether they were specific to brain injuries or whether they changed during any trauma to any part of the body. All of the people had their blood drawn 19 times, starting at within four hours of their injury and up to 7 days later. By tracking changes in the levels of the two proteins over this time, Papa could see how they changed, and correlate that with the people’s symptoms.
In all people, regardless of the type of injury, the levels of the proteins, called GFAP and UCH-L1, rose within the first hour after the injuries. When Papa looked just at people who showed signs of TBI on CT scans, she found that their levels of GFAP and UCH-L1 were significantly higher than those of people with other types of trauma, which suggested that the two markers can be relatively specific to TBI and not trauma in general.
“We don’t want to do any unnecessary procedures on people who don’t need them,” says Papa of using CT scans to distinguish people with more serious head injuries from those how just have hit their head but don’t experience any symptoms. “I don’t think a blood will be the be-all and end-all but it would be a beautiful tool for us to have in the clinic to support a lot of our decision making”, she added.