Traumatic brain injury (TBI) is one of the dominant causes of death and disability in the United States. The leading cause for TBI is from falls, although car accidents, blunt trauma and assaults are also major contributors. Classed as either ‘mild’ or ‘severe,' current diagnosis and monitoring relies on CT and MRI scans, both of which can be costly and time-consuming.
Researchers from the University of Pittsburgh Medical Center, however, believe they’ve shown that a blood test can accurately identify if a patient has suffered TBI, and to what severity. By measuring the amount of a specific protein released into the bloodstream after injury, the team were able to reduce the number of unnecessary CT scans by up to 30%.
Scientists have been looking for some time for a biomarker that might be able to identify TBI. In this latest effort, published in the Journal of Neurotrauma, researchers decided to focus their attention on a central nervous system molecule called glial fibrillary acidic protein (GFAP) and its breakdown products. GFAP gets released into the area surrounding cells following injury to the nervous system, so scientists wanted to evaluate whether assessing its levels, alongside the breakdown products, in patient blood samples could indicate the presence of TBI.
After examining more than 200 patients between the ages of 16-93, all of whom were treated at trauma centers with TBI, they found that GFAP and its breakdown products could serve as viable early indicators of intracranial injury. According to the authors, this suggests that measuring these molecules following head injury could be useful in conjunction with traditional methods.
Where other studies have failed, this one has been able to demonstrate “that [the protein] offers good predictive ability, significant discrimination of injury severity, and net benefit in reducing the need for unnecessary scans, all of which have significant implications for the brain injured patient," says Dr. John Povlishock, editor in chief of the Journal of Neurotrauma.
Every year, around 1.5 million people in the United States are diagnosed with TBI. The injury leads to a range of symptoms: Those who suffer mild forms can experience headaches, memory loss, loss of smell or mood changes. Severe injury, which results when a patient loses consciousness for more than 30 minutes, can cause even more damaging problems such as loss of speech, confusion, seizures and paralysis.
These complications can be difficult not just for the sufferer but for those around them too, as the person they thought they knew has suddenly changed. In critical cases, it can even cause death. According to the Centers for Disease Control and Prevention, TBI contributes to more than 50,000 deaths a year.
What the study was not able to evaluate, however, was whether the levels of protein in the blood decreased as the patient recovered and symptoms decreased. Hopefully, though, this new blood test could allow doctors to monitor and assess patients who have or are at risk from traumatic brain injury more effectively than relying on CT scans alone.