Researchers at Children’s Health Research Institute, a program of Lawson Health Research Institute and affiliated with Western University, say they have developed a new blood test that can diagnose with great accuracy whether an adolescent athlete has suffered a clinically significant concussion or mild traumatic brain injury.
Concussions and mild traumatic brain injuries are currently diagnosed through a combination of patient symptom assessment and the judgement of a clinician, said Dr. Douglas Fraser, the Lawson scientist who led the study. Mark Daley, a professor at Western’s Departments of Computer Science, Biology, and Statistics & Actuarial Sciences, co-investigated the study.
“It’s based on clinical judgement,” said Fraser, who is also a physician in the Paediatric Critical Care Unit at LHSC’s Children’s Hospital. “Usually there’s a witness mechanism of injury, and then there are typical symptoms that follow.”
While generally accurate, the procedure, he says, has its problems. For example, when a person with a history of headaches or anxiety is being assessed for a possible concussion. “Are those symptoms due to the concussion or due to something previously going on with the person? It’s an imperfect diagnosis at this point and time, but generally we do well,” said Fraser.
This recent study involved a relatively inexpensive test, where blood was drawn from an individual that may have suffered a concussion or head trauma within 72 hours of the incident.
Using a form of blood profiling called metabolomics, the study of a person’s metabolites in their body, researchers were able to compare the blood of someone who had suffered a concussion to the blood of someone who hadn’t. Fraser says they assumed the metabolites of someone who had suffered a concussion would be “a little bit different.”
“Based on the blood work alone, we found we were greater than 90 per cent accurate in determining who had had a concussion, a clinically significant concussion,” said Fraser, adding they hope the tests aid not only with diagnostics, but also prognosis.
“In general we always say there should be cognitive and physical rest after a concussion, but more and more frequently we’re seeing studies where we’re testing those ideas to see what we can do to intervene, and where we can do better, and this will hopefully help us along the way to have a better understanding on how the brain heals and when someone is ready to get back to their daily activities,” said Fraser.
Fraser says this new method, fully funded by the Children’s Health Foundation and conducted by the Western Concussion Study Group, is unique in that previous attempts have looked unsuccessfully for a single highly accurate protein biomarker that can distinguish concussed from non-concussed adolescent patients.
Previous research, he says, mostly looked at one or two molecules floating around in the blood.
“Up until now, the results have been not adequate, so we took a different approach, where we decided to look at a whole bunch of different things floating around in blood, in fact we looked at 174 metabolites, and we then did some fairly advanced analytics and found that the patterns were different when you look at large numbers of molecules, as opposed to just one or two,” said Fraser.
“It’s been an evolving type of work, and it just turned out extremely well.”
The results of the study were published recently in the journal Metabolomics.
(With files from Matthew Trevithick, Devon Peacock)