Tagged with “biomarkers”
American Academy of Neurology publishes an important study showing consistent evidence of axonal injury following a single TBI for years after injury using multiple measures, including a blood biomarker, MRI/DTI and volumetric analysis, and functional tests
On July 8, 2020 the American Academy of Neurology published an important study advancing our understanding of, and ability to diagnose, traumatic brain injury (TBI). The study, Shahim P, Politis A, van der Merwe A, et al. Time course and diagnostic utility of NfL, tau, GFAp, and UCH-L1 in subacute and chronic TBI was published online ahead of print, 2020 Jul 8 in Neurology. Funding for the study was provided by the National Institutes of Health and the Department of Defense (Center for Neuroscience and Regenerative Medicine.)
The authors of the study conclude as follows:
“ In summary, these findings suggest that a single mild to moderate TBI may cause long-term neuroaxonal degeneration and astrogliosis/activation.”
Researchers from Berkeley, Duke, UNC Chapel Hill and University of Arizona used a new type of MRI called “diffusion kurtosis imaging” (“DKI”) to take brain scans of 16 high school football players, ages 15 to 17, before and after a single season of football. DKI is an extension of Diffusion Tensor Imaging, (DTI) discussed in prior posts. Early studies suggest that it outperforms DTI in capturing certain microstructural changes in the brain. The football players who were scanned all wore helmets and none of them were diagnosed with a concussion. The researchers also measured head impact exposure during every practice and game using the Head Impact Telemetry (HIT) system, which has been widely used in other head impact studies. The study, which is the cover story of the November issue of the journal Neurobiology of Disease, is one of the first to look at how impact sports affect the brains of children at this age.
In recent years a great deal of research has been done to identify an objective “biomarker” of concussion. As reported in this blog, some promise has been found in blood biomarkers (measuring plasma tau protein levels) and neuroimaging, such as the DTI MRI sequence. Unfortunately, these approaches are invasive and/or expensive and are not always a reliable indicator of concussion and concussion recovery. As reported in our November 27, 2016 blog post, until now, one of the most promising concussion screening tools was a series of vision tests endorsed by the Department of Defense.
Scientists at Northwestern University have now found a related, and what appears to be an even more precise and accurate tool, a measure of the brain’s electrophysiological response to sound. Read More
The University of Pennsylvania Perelman School of Medicine issued a press release on November 23, 2015 declaring “mild brain injury an oxymoron” based on newly released research. The research, performed in collaboration with the University of Glasgow, demonstrates how brain wiring can be damaged after a concussion–damage that in some cases never repairs.
The research, published online in November in Acta Neuropathologica, builds on prior studies showing that nerve fiber damage in the brain can be demonstrated by the presence of a brain protein called SNTF. Read More
Research from the National Institute of Health, published in the August 3, 2015 issue of JAMA Neurology, shows that a protein that was until recently linked only to acute symptoms following traumatic brain injury, may also be responsible for chronic neurological symptoms, such as headache and dizziness, found in patients diagnosed with persistent post-concussion syndrome.
Tau is a protein known to play a significant role in the development of Alzheimer’s disease and Parkinson’s disease. Using ultra-sensitive technology, the researchers measured levels of tau in the blood months and years after injury. These levels correlated with the severity of post-concussive symptoms. If these findings are further confirmed, this could be the first biomarker that is sensitive and specific to ongoing TBI symptoms. Read More
Findings released on November 25, 2014 in the Journal of Neurotrauma indicate that the presence of a blood protein known as SNTF shortly after a sports-related concussion can predict the severity of post-concussion symptoms in professional athletes.
The authors of the study – Robert Simon, PhD, and Douglas H. Smith, MD, professor of neurosurgery and director of the Center for Brain Injury and Repair at the University of Pennsylvania – noted upon release of this study of SNTF in concussion patients that
“these observations lend further support to the growing awareness that concussion is not trivial, since it can induce permanent brain damage in some individuals.” Read More
In a study published November 18, 2013 in Frontiers in Neurology, researchers from Penn and Baylor report that they have identified a blood biomarker – SNTF – that if found on the day of injury predicts with substantial accuracy both cognitive impairment persisting more than 3 months and the existence of abnormal brain imaging finding in the corpus callosum and uncinate fasciculus of the brain (using diffusion tensor imaging (DTI). Read More
The August issue of the Journal of the American Medical Association (JAMA) includes a “Viewpoint” by two leading neuroscientists promoting the use of an “International Knowledge-Based Approach” to traumatic brain injury (TBI).
One of the causes of the failure of clinical trials to successfully treat TBI, the authors contend, is the common classification of TBIs as “mild, moderate or severe.” These classifications do not incorporate newer insights and findings from diagnostic tools such as imaging and biomarkers and therefore do not promote “mechanistic targeting” for clinical trials. The authors support the transition to a more nuanced approach, a precise disease classification model that is based on the precise pathoanatomical and molecular features of the injury. Read More
Concussion, or mild traumatic brain injury (TBI), typically produces no gross pathology, such as hemorrhage or abnormalities, that can be seen on conventional CT scans of the brain. It does cause rapid-onset neurophysiological and neurological dysfunction that in most patients resolves spontaneously over a fairly short period of time. Studies have shown, however, that approximately 15% of individuals with mild TBI develop persistent cognitive dysfunction and other symptoms. Researchers are starting to make progress on proving mild traumatic brain injury using the biomarkers that underlie such symptoms. Read More