[Kenjhee]

I just heard on the radio: a scientific study that links the type of injury caused by TBI, especially war veterans, with the CTE experienced by some athletes. The bad news: TBI is now linked with a degenerative condition. The good news: they may have found a physical marker, specifically the TAU protein compacted into certain tissues, that can serve as a diagnostic tool.

I don't know if there's a way to detect these protein clumpings in vivo, but it's still exciting to know there's a real and discrete physical component to what we're suffering. Also, I believe the effects of the TAU protein are fairly well known, so it's a good one to "choose".

Here's the link: Does brain injury link NFL players, wounded warriors?

[Mark in Idaho]

The TAU protein and another called S-100B have been studied for quite some time. The big question is will it change the treatment?

[Kenjhee]

I'd be happy if it only leads to a diagnostic technique that doesn't require dissection.

Isn't it a (relatively) straightforward matter of tagging a monoclonal TAU anti-body with a radio-isotope? Just guessing out loud here.

[Mark in Idaho]

The Tau test is cheap (<$10 wholesale plus lab time) but it requires a spinal puncture with the related risks. The lab test I found uses a rabbit antibody specific for Tau. http://products.invitrogen.com/ivgn/product/KHB0041

It is the same test used for Alzheimer's Disease. The overlap in diagnosis could be problematic. There would need to be a differential to rule out AD. There already exists a problem differentiating AD from CTE once the subject reaches 40 years old or so. There is a tendency to diagnose Early Onset AD for for just about any unexplained dementia that onsets in the 40's.

qEEG has a 97 to 99% accuracy. Probably about the same cost overall.

[GlassHead]

They are now able to detect amyloid plaques in PET scans:

http://medicalxpress.com/news/2012-0...r-disease.html

-GlassHead

[GlassHead]

And btw, they also hope to get a blood test out in the end of 2012, that can diagnose mtbi:

http://thechart.blogs.cnn.com/2010/1...rain-injuries/

[Concussed Scientist]

It would be great to have a blood test, but I think that such tests will only detect a relatively recent brain injury, as is the case for a heart attack. There will be a window of time when the damage can be detected. So, it isn't really going to be useful for the likes of us who have had a brain injury some time ago.

I think that S100B, which is released from damaged astrocytes could be part of the test - the announcement doesn't mention which proteins are involved. I believe S100B is already used in Germany to detect concussions, so it could be used worldwide, it just needs to be set up in emergency rooms as a standard.

When I had my concussion, no one even took blood. I assume this is probably most people's experience. Even if as sample had been frozen, the test could be done years later, but if no sample was taken, then it won't be possible to detect anything at a much later date. That means that, sadly, the technique is unlikely to be useful in the monitoring of PCS or recovery from it. It will be a big advance though if emergency rooms can tell which patients are likely to have had a more serious concussion. Nowadays serious concussions can get missed.

CS

Originally Posted by GlassHead

And btw, they also hope to get a blood test out in the end of 2012, that can diagnose mtbi:

http://thechart.blogs.cnn.com/2010/1...rain-injuries/

[GlassHead]

Yes, the blood test is only for acute phase mtbi´s, I just thought it was an interesting article

[Kenjhee]

I was envisioning (as long as we're fantasizing) more of a tagged imaging technique, vs. (or in addition to) an assay. It's not just the presence of the TAU bodies, it's their architecture as clumped masses in relevant CNS tissue. Maybe more like the mentioned flourene-tagging amyloids under PET scan. Plus it avoids the LP.

Both assays and scans are necessary. Assay for basic detection, with a blood test being minimally invasive and supporting immediate post-trauma testing. Scan for functional diagnosis, e.g. what areas of the brain/spinal cord are affected.

There exists still the problem of differentiation from Alzeimers. Hopefully there is some kind of structural or histological differences, after all they are different disorders, despite the amount of overlap.