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The Path Toward a Blood Test for Concussion: A Review of Biofluid Biomarkers for Concussive and Subconcussive Brain Trauma

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Tackling the Concussion Epidemic

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Abstract

The pursuit of a blood test for traumatic brain injury (TBI), and more specifically concussion, has been very active over the last decade with a barrage of publications seeking the best biomarkers for the job. As with other organ-based diseases, the employment of a rapid, accurate, and widely available blood test to guide diagnosis and treatment of TBI and concussion would be a welcome clinical tool. Such a blood test has considerable diagnostic and prognostic promise given the number of critical applications it would have. Early human trials examined only moderate-to-severe TBI but are now expanding to include injuries on the milder end of the TBI spectrum, such as concussion and subconcussive injuries. In the USA, two biomarkers have now been FDA-approved for clinical use in adult patients with mild-to-moderate TBI to help determine need for CT scan acutely after injury. More work is now being done to detect concussive and subconcussive injuries. Mechanism and severity of injury, timing of sample collection, type of biofluid collected, biokinetic profiles of select biomarkers, and individual patient physiology can all impact biomarker release following concussion. Careful consideration of these factors will be essential when designing future concussion biomarker studies and interpreting results. As technology advances and integrates neuroproteomics, metabolomics, bioinformatics, genetics, and neuroimaging, the path from discovery to validation of potential TBI biomarkers will be swift. This chapter will review the most widely studied proteomic biomarkers for mild TBI and concussion in humans and will introduce a novel group of promising transcriptomic biomarkers.

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  1. Department of Emergency Medicine, Orlando Health, Orlando Regional Medical Center, Orlando, FL, USA

    Linda Papa

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  1. Keenan Research Centre, St. Michael’s Hospital, Unity Health Toronto and University of Toronto (Neurosurgery), Toronto, ON, Canada

    Tom A. Schweizer

  2. Departments of Critical Care and Anesthesia, St. Michael’s Hospital, Unity Health Toronto and University of Toronto, Toronto, ON, Canada

    Andrew J. Baker

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Papa, L. (2022). The Path Toward a Blood Test for Concussion: A Review of Biofluid Biomarkers for Concussive and Subconcussive Brain Trauma. In: Schweizer, T.A., Baker, A.J. (eds) Tackling the Concussion Epidemic. Springer, Cham. https://doi.org/10.1007/978-3-030-93813-0_4

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