A major study is planned to evaluate the new test. The Department of Defense has announced that it is funding the research to determine if particular proteins are reliable markers for concussions, a mild form of traumatic brain injury (TBI), a potentially serious condition that not only affects many members of the armed forces but also a growing number of athletes. The study, set to begin this year, will continue over 18 months and will involve over 1,200 patients from 30 trauma centers across the US and overseas.
Researchers will investigate whether the test can accurately assess individuals for brain injuries and identify those who need treatment. The new study follows on the promising results of smaller ones that found that levels of certain proteins rise in the cerebrospinal fluid after brain cells have undergone trauma. By expanding the study, scientists hope to determine whether blood levels of these proteins are likewise affected and if the observed increases are unique to brain injury and not affected by other factors or conditions in the body. Bio-markers, such as the brain proteins ubiquitin C-terminal hydrolase (UCH-L1) and S100 calcium binding protein B (S100B), have shown some potential.
Concussions are a major health concern, often affecting the lives of military personnel as well as those of professional and student athletes. Over 1.7 million people suffer from a concussion or traumatic brain injury each year, according to the CDC. Of these, 52,000 individuals die. There has been heightened awareness of the dangers of concussions, especially repeated concussions within a short time, that don't allow the brain to heal adequately. Brain injuries in young athletes, especially recurrent ones seen in contact sports, can have harmful, long-term effects on their health. Head injuries such as these may be a contributing risk factor to Alzheimer disease.
Concussions are sometimes difficult to spot, especially if there are no outward signs or symptoms such as headache, vomiting, dilated pupils, or loss of consciousness. Some brain injuries are relatively mild and show no overt signs but still pose a risk of serious complications. This type of injury can be particularly dangerous in that medical help may not be immediately sought, resulting in delayed treatment.
The Department of Defense has been looking for years for a more effective way to detect brain injuries, even mild ones, in order to improve the treatment of soldiers affected by them. A simple blood test that would aid in the diagnosis and prognosis of concussions would be welcomed by many in the medical community. Key funding has been awarded to the company developing the blood test, a test that would be more efficient, relatively simple to perform, and inexpensive in addressing TBI.
The Army has expressed optimism about the test, yet some medical experts say there are several obstacles to overcome in developing a truly useful blood test. Concerns in the utility of such a test are in its ability to differentiate between mild and severe injuries and understanding any differences between adults and children.
Further studies are underway to address these concerns and others. If proven useful and approved by the US Food and Drug Administration, this test could be marketed for use in clinical practice, although this would be some years in the future.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
(July 20, 2010) Burton T. New Test for Brain Injury on the Horizon. Wall Street Journal. Available online at http://online.wsj.com/article/SB10001424052748704720004575377082786936708.html through http://online.wsj.com. Accessed December 2010.
(August 17, 2010) Banyan Biomarkers. About Biomarkers. Available online at http://banyanbio.com/?page_id=207. Accessed December 2010.
Centers for Disease Control and Prevention. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006. Available online at http://www.cdc.gov/traumaticbraininjury/tbi_ed.html through http://www.cdc.gov. Accessed January 2011.
Papa L, et. al. Ubiquitin C-terminal hydrolase is a novel biomarker in humans for severe traumatic brain injury. Critical Care Medicine. January 2010, Volume 38, Issue , Pp 138-144. Abstract available online at http://journals.lww.com/ccmjournal/Abstract/2010/01000/Ubiquitin_C_terminal_hydrolase_is_a_novel.22.aspx through http://journals.lww.com. Accessed December 2010.
Liu M. Ubiquitin C-terminal hydrolase-L1 as a biomarker for ischemic and traumatic brain injury in rats. European Journal of Neuroscience. February 2010, Volume 31, Issue 4, Pp 722-732. Abstract available online at http://onlinelibrary.wiley.com/doi/10.1111/j.1460-9568.2010.07097.x/abstract through http://onlinelibrary.wiley.com. Accessed December 2010.