A new blood test shows promise in helping detect and define levels of brain trauma even years after the injury.
As we have discussed before, any injury to the brain is serious. Brain injury can result from a traumatic blow to the head or after the brain is deprived of oxygen during a surgical event or other accident. Diagnosis of a traumatic brain injury (TBI) is difficult at best, and can call for imaging or invasive tests.
In the US, TBI is a leading cause of disability and death. The Centers for Disease Control and Prevention (CDC) estimates more than 2.87 million emergency department visits, hospitalizations, and deaths occur due to TBI, with about 837,000 of those events related to children. The most common brain injury is minor concussion which can have cognitive, emotional, and physiological consequences long after the injury. Diagnosis and focused treatment are key to reducing or minimizing the long-term impacts of TBI when possible.
Ongoing Quest to Identify a Biomarker
At present, there is no simple blood test that physicians can use to obtain a view of what has occurred in the brain. The quest is to identify a biomarker in the blood that can reliably identify levels of brain injury now, and five years down the line. Previous research has focused on brain proteins that exist in higher volume after a brain injury. Yet in the blood, those proteins do not provide the differentiated view that is needed for diagnosis.
Research recently discussed in the journal Neurology may offer a break in the search for a reliable blood test for traumatic brain injury. The spotlight is on a biomarker called a neurofilament light chain. Neurofilaments are structural components of axons. Axons are the threadlike tentacles of a nerve cell that allow it to communicate with other cells. There are three types, or a triplet, of neurofilaments. One of those is the neurofilament light chain (NF-L).
The neurofilament triplet was first discussed in 1996 as a possible marker for measuring damage that occurs in diseases like amyotrophic lateral sclerosis (ALS), stroke, and Alzheimer’s disease, among others. Measurement of NF-L has often been used in animal studies, and may now prove a centerpiece in a non-invasive blood test for brain injury.
Of the current research, study author, Dr. Pashtun Shahim notes, “Currently, there is no validated biomarker that can reliably detect the subtle signs of brain injury months to years after a traumatic brain injury. Our study shows that the amount of serum NfL was higher even at five years after a single traumatic brain injury, while the other proteins we measured in this study, although, detectable in blood, were not high enough to distinguish patients from controls.”
After a TBI, the NF-L breaks off and accumulates in the blood and in cerebrospinal fluid. Researchers looked at data from two study groups to assess the reliability of NF-L as a biomarker for brain injury. One group was a Swedish hockey club, while the other group consisted of patients with brain injuries from a clinic in Maryland.
Glimmers of Light Amidst Tragedy
The research on an NF-L blood test found that it tracks with NF-L in spinal fluid, can identify mild, moderate, and severe brain injury, and is useful for helping determine when an athlete—or non-athlete—could return to sports or their usual activities.
While we have treatments that can reverse TBI, hopefully soon we will have tools to help us diagnose TBI accurately and less invasively.
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