The researchers find that the Many patients with concussion have normal CT scans and are discharged from the hospital without follow-up. But a blood test that is currently under development; and costs a fraction of the price of a brain scan may flag concussion in these CT-negative patients; enabling them to be evaluate for long-term complications. In a study led by UC San Francisco; researchers tracked 450 patients with suspect traumatic brain injury (TBI); which includes concussion or mild TBI who had been admit to one of 18 level 1 trauma centers throughout the nation.
Concussion have normal CT scans
The patients, whose injuries were mainly attribute to traffic accidents or falls, all had normal CT scans; according to the study publishing in The Lancet Neurology on Aug. 23, 2019. Within 24 hours of their accidents; the patients had their blood drawn to measure for glial fibrillary acidic protein; a marker correlating to TBI. The study used a device by Abbott Laboratories called i-STAT Alinity, a handheld portable blood analyzer; currently unavailable in the U.S., that produces test results in minutes.
The researchers later confirmed the blood test results against MRI; a more sensitive and expensive scan that is not as widely available as CT but offers a more definitive diagnosis of TBI. Therefore They found that 120 of these 450 patients (27 percent) had an MRI that was positive for TBI. But ‘Patients with TBI Are Not Even Getting a; Diagnosis‘ “Our earlier research has shown that even in the best trauma centers, patients with TBI are not getting the care they need;” said Geoffrey Manley, MD, Ph.D., senior author of the study; professor of neurosurgery at UCSF and a member of the Weill Institutes for Neurosciences.
Group of healthy participants
“Now we know that many of these patients with TBI are not even getting a diagnosis.” Manley is also the principal investigator of TRACK TBI; which has analyzed clinical data on more than 3,300 patients and comparison participants; and previously has linked concussion with major depression, post-traumatic stress disorder and cognitive deficits. Work by other UCSF faculty has found correlations between TBI and Parkinson’s disease and TBI and dementia.
To assess the accuracy of the blood test; researchers compare the results of the patients whose CT-negative TBIs were confirmed by MRI; with a group of healthy participants as well as a cohort of patients with orthopedic injuries. They found that the average protein value of the blood samples of patients with positive MRIs was 31.6 times higher than those with orthopedic injuries and nearly 52 times that of the healthy participants. The protein is elevated even in the patients with normal MRIs, suggesting that the test may be sensitive to injury undetectable by MRI; the researchers noted.