Recently, researchers developed a test in which a new blood biomarker accurately predicted long-term cognitive dysfunction following a mild traumatic brain injury (TBI). The test identified concussion patients who each went on to develop white matter tract structural damage.
Blood Test may Identify Concussion Patients at Risk of Long-Term Deficits
Researchers from the Perelman School of Medicine at the University of Pennsylvania teamed up with industry colleagues at Baylor College of Medicine in a blood analysis study using mild TBI patients. The team discovered that the blood levels of a protein called calpain, cleaved αII-spectrin N-terminal fragment (SNTF), were twice as high in a subset of patients following a mild traumatic brain injury. If the results are validated in larger studies, this blood test could identify those concussion patients who are at an increased risk for persistent cognitive dysfunction or further brain damage if they return to competitive sports or military combat duties.
According to the CDC, over 1.5 million children and adults suffer concussions each year in the US. Since the wars in Afghanistan and Iraq began in 2001-2003, hundreds of thousands of military personnel have endured mild traumatic brain injuries. Up to this point, the existing tests have not been capable of determining the extent of a brain injury or whether the patient will be among the 15-30 percent who experience significant, persistent cognitive deficits, including processing speed, memory impairment and the ability to balance multiple thoughts.
The study’s lead author Robert Siman, PhD, research professor of Neurosurgery at Penn., explained:
“New tests that are fast, simple, and reliable are badly needed to predict who may experience long-term effects from concussions, and as new treatments are developed in the future, to identify who should be eligible for clinical trials or early interventions. Measuring the blood levels of SNTF on the day of a brain injury may help to identify the subset of concussed patients who are at risk of persistent disability.”
Douglas Smith, MD, director of the Penn Center for Brain Injury and Repair and professor of Neurosurgery, supported Siman’s statement by saying:
“The blood test identified SNTF in some of the orthopaedic injury patients as well, suggesting that these injuries could also lead to abnormalities in the brain, such as a concussion, that may have been overlooked with existing tests. SNTF as a marker is consistent with our earlier research showing that calcium is dumped into neurons following a traumatic brain injury, as SNTF is a marker for neurodegeneration driven by calcium overload.”
Test Results Show Remarkable Accuracy among Mild TBI Patients
When the blood test was administered on the day of the concussion, results showed 100 percent sensitivity to predicting concussions that would lead to persisting cognitive problems and 75 percent specificity to accurately rule out those without harmful concussions who were not likely to experience any long term consequences.
The next step is to conduct the study at a larger level, with a wider range of test subjects. If validated at larger levels, the blood test measuring levels of SNTF is likely to help in diagnosing and predicting risk of experiencing long term consequences after even just one concussion.
The Penn and Baylor research teams also hope to use a larger study to determine the optimal time after concussion at which SNTF in the blood should be measured in order to maintain consistent, accurate test results. The team also wants to evaluate their blood test for its potential in identifying precisely when repetitive concussions start to cause brain damage and persistent disability.
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