We have often said that concussions can be tricky to spot because they have many invisible symptoms that aren’t as obvious as the signs of many other injuries, such as a broken arm or sprained ankle. Traumatic brain injuries (TBIs) aren’t easily detected by many of the tools we normally use to assess injuries: MRIs, Cat Scans, x-rays and blood tests. But exciting new research is uncovering an exciting new connection between blood-based biomarkers and TBI, meaning the future may hold blood-testing tools that can help accurately diagnose concussions and more.
What Is the Connection Between Blood-Based Biomarkers and TBI?
At the end of August, a new study identifying blood-based biomarkers that could help to predict which athletes need additional time to recover from concussions was published in The Journal of the American Medical Association (JAMA). Researchers from the multicenter diagnostic Concussion Assessment, Research, and Education (CARE) Consortium study, conducted by the National Collegiate Athletics Association (NCAA) and the Department of Defense, assessed data collected data from 127 male and female collegiate athletes from across the country who had sustained a sports-related concussion. These patients had their plasma biomarkers (which serve as objective indicators) tested at several time points: shortly after injury, when their symptoms resolved, and one week after returning to play. Each athlete had also undergone preseason baseline testing.
Tau Protein and Glial Fibrillary Acidic Protein (GFAP)
Using an ultrasensitive screening tool that can detect minute amounts of protein, the researchers tested blood serum from these athletes and identified two blood proteins that were associated with the length of time needed by the athletes to return to play. Amounts of these two proteins, tau protein and glial fibrillary acidic protein (GFAP) were found to be significantly different in athletes who needed less or more than 14 days to return.
While further research is needed, the results of this study are an important step towards the development of a test that could help predict which athletes need more time to recover from a concussion and resume activity.
More Promising Research on Blood-Based Biomarkers and Concussions
As if the plasma biomarker study on when athletes may safely return to play wasn’t exciting enough, earlier this summer scientists at the National Institutes of Health (NIH) Clinical Center recently published a study on something called the neurofilament light chain (NfL), a protein in the blood. Levels of this protein are already studied as it relates to dementia, stroke, movement disorders and more. Now we think it may help indicate neurological damage as well.
NIH scientists studied Swedish and American hockey players between 2011 and 2019 who, at some point, had experienced concussions. The scientists discovered that levels of NfL were significantly increased whether individuals had experienced mild, moderate or severe traumatic brain injury. These findings suggests to us as that even mild concussions, those without any seemingly visible signs of damage, can cause long-term effects. And that the serum NfL can assist as a valuable biomarker for us even years after a patient suffers a head injury. There seems to be no doubt that blood tests using blood biomarkers will one day become valuable tools in helping us determine safe return to play, work or normal activities.
Diagnosing TBI
This is all groundbreaking and exciting research, but TBI patients will still need neurocognitive testing along with any sort of biomarker blood test. These tests are not either-or — they go hand-in-hand to improve concussion assessments and treatment.
Blows to the head can cause the brain to be smacked around the skull, which, even in a mild concussion, is what we term mild TBI. This condition can result in various physiological impairments. While, thankfully, most concussions are mild, diagnosing concussions can be challenging since they normally don’t show up in an MRI or CT scan.
Think You Have a Concussion?
If you think you’ve suffered a concussion, it’s important you seek medical assistance and follow any protocols your doctor or therapist suggests. At the MAC Alliance, we utilize a variety of great concussion testing tools to assist us in diagnosing and evaluating concussions. We screen for brain injuries using easy-to-use, web-based platforms like the FDA-approved ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) test. Another tool, from Cambridge Brain Sciences, also provides us with accurate and scientifically validated ways to measure cognition, (basically the way we think). Best yet, we can often, if necessary, conduct these tests remotely.
Is it a Concussion if You Weren’t Knocked Out?
You could have suffered a concussion even if you weren’t knocked unconscious. In fact, approximately 90% of individuals who have concussions don’t report losing consciousness. Individual symptoms following a head injury vary greatly depending on a lot of factors including your age, sex, concussion history, history of migraine headaches and more. Symptoms also don’t always show up immediately—you could experience them hours or even days after the injury. Contact your healthcare provider to be safe!
