Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 04-21-2016, 07:02 AM #1
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Default A blood test for TBI/concussion

Recently it has been shown that two brain proteins (GFAP and UCH-L1) are released into the blood after brain injury.

This looks like a promising new approach.

There is a general account of this here https://www.sciencedaily.com/release...0328114638.htm and the Abstract of the paper is here http://archneur.jamanetwork.com/arti...icleid=2506517.
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Old 04-21-2016, 11:11 AM #2
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These blood tests sounds good. I reported on this 3/29. Now that the JAMA articles is linked, I was hoping for more details. It requires an expensive subscription to see the details.

The abstract of the research says the blood test results were cross checked with CT Scans for lesions. It does not say how well it identifies concussions that do not show in a CT Scan like 99% of concussions. It would be interesting to see the results cross checked to high Tesla MRIs of 6 or higher Tesla. High Tesla MRIs can show the fine damage from concussions.

It would also be good to know the cost of these simple but specific blood tests.

Here is a great review of the full article with some details not mentioned previously.
http://www.healthnewsreview.org/news...le-blood-test/

The 2 key issues are:

Of those who had a positive result from the GFAP test, 47% had an imageable brain lesion. What about the 53% who tested positive but did not have an imageable brain lesion ? Were they tested using other concussion diagnostics ? Did they suffered concussions without a brain lesion or contusion like the vast majority of concussions ?

The blood test is expected to be available in 5 years if continuing research supports it. It sounds like an expensive test.

Based upon the information I can find, the test sounds similar to an existing diagnostic test that I am familiar with that costs $800.

The second test, UCH-L1 sounds like it has a similar cost.

Maybe Banyan Biomarkers, the company behind the research will develop a lower cost test.
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Old 04-21-2016, 06:31 PM #3
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"It would also be good to know the cost of these simple but specific blood tests."

Mark, from a look at the Banyan Biomarkers site, they are measuring blood biomarkers using an immunoassay (an ELISA).

The consumables in an ELISA are cheap and ELISA take about a day to do so there would be wages for the technician doing his/her day's work. There would probably also be some depreciation of the equipment involved (multi-channel pipettes, a plate-reader, etc).

I think that $800 a go for an ELISA covers the costs involved by a very big margin.
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Old 04-21-2016, 07:30 PM #4
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The information I found describes the current tests as similar to a FISH test. Expensive staining and processing. If Banyan can develop a specific immunoassay, that would be great. Maybe Theranos could develop an affordable test and make it widely available.

The challenge is can this help with the run of the mill concussions as a tool to keep players off the field and get insurers to take notice of a need for care. If the 53% false positive for imageable brain contusion is actually a less severe concussion, the test would be more valuable. It would be great to have a test administered like a blood glucose test with a remote reporting to the team doc.

With the number of concussions that never make it to a doctor, there needs to be a way to affordably diagnose them without incurring the expensive doc visits that teams and patients want to avoid.

Time will tell if this will be a positive event for the mildly or moderately concussed.
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