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Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury

Mild traumatic brain injury (TBI) and concussion can have serious consequences that develop over time with unpredictable levels of recovery. Millions of concussions occur yearly, and a substantial number result in lingering symptoms, loss of productivity, and lower quality of life. The diagnosis may...

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Autores principales: Rauchman, Steven H., Pinkhasov, Aaron, Gulkarov, Shelly, Placantonakis, Dimitris G., De Leon, Joshua, Reiss, Allison B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10650880/
https://www.ncbi.nlm.nih.gov/pubmed/37958226
http://dx.doi.org/10.3390/diagnostics13213330
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author Rauchman, Steven H.
Pinkhasov, Aaron
Gulkarov, Shelly
Placantonakis, Dimitris G.
De Leon, Joshua
Reiss, Allison B.
author_facet Rauchman, Steven H.
Pinkhasov, Aaron
Gulkarov, Shelly
Placantonakis, Dimitris G.
De Leon, Joshua
Reiss, Allison B.
author_sort Rauchman, Steven H.
collection PubMed
description Mild traumatic brain injury (TBI) and concussion can have serious consequences that develop over time with unpredictable levels of recovery. Millions of concussions occur yearly, and a substantial number result in lingering symptoms, loss of productivity, and lower quality of life. The diagnosis may not be made for multiple reasons, including due to patient hesitancy to undergo neuroimaging and inability of imaging to detect minimal damage. Biomarkers could fill this gap, but the time needed to send blood to a laboratory for analysis made this impractical until point-of-care measurement became available. A handheld blood test is now on the market for diagnosis of concussion based on the specific blood biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl terminal hydrolase L1 (UCH-L1). This paper discusses rapid blood biomarker assessment for mild TBI and its implications in improving prediction of TBI course, avoiding repeated head trauma, and its potential role in assessing new therapeutic options. Although we focus on the Abbott i-STAT TBI plasma test because it is the first to be FDA-cleared, our discussion applies to any comparable test systems that may become available in the future. The difficulties in changing emergency department protocols to include new technology are addressed.
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spelling pubmed-106508802023-10-28 Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury Rauchman, Steven H. Pinkhasov, Aaron Gulkarov, Shelly Placantonakis, Dimitris G. De Leon, Joshua Reiss, Allison B. Diagnostics (Basel) Review Mild traumatic brain injury (TBI) and concussion can have serious consequences that develop over time with unpredictable levels of recovery. Millions of concussions occur yearly, and a substantial number result in lingering symptoms, loss of productivity, and lower quality of life. The diagnosis may not be made for multiple reasons, including due to patient hesitancy to undergo neuroimaging and inability of imaging to detect minimal damage. Biomarkers could fill this gap, but the time needed to send blood to a laboratory for analysis made this impractical until point-of-care measurement became available. A handheld blood test is now on the market for diagnosis of concussion based on the specific blood biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl terminal hydrolase L1 (UCH-L1). This paper discusses rapid blood biomarker assessment for mild TBI and its implications in improving prediction of TBI course, avoiding repeated head trauma, and its potential role in assessing new therapeutic options. Although we focus on the Abbott i-STAT TBI plasma test because it is the first to be FDA-cleared, our discussion applies to any comparable test systems that may become available in the future. The difficulties in changing emergency department protocols to include new technology are addressed. MDPI 2023-10-28 /pmc/articles/PMC10650880/ /pubmed/37958226 http://dx.doi.org/10.3390/diagnostics13213330 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Rauchman, Steven H.
Pinkhasov, Aaron
Gulkarov, Shelly
Placantonakis, Dimitris G.
De Leon, Joshua
Reiss, Allison B.
Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury
title Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury
title_full Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury
title_fullStr Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury
title_full_unstemmed Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury
title_short Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury
title_sort maximizing the clinical value of blood-based biomarkers for mild traumatic brain injury
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10650880/
https://www.ncbi.nlm.nih.gov/pubmed/37958226
http://dx.doi.org/10.3390/diagnostics13213330
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