New blood test for brain injury at URMC

Jul 26, 2018

Researchers at the University of Rochester Medical Center have a new, FDA-approved test to detect brain injuries, according to a study published Wednesday in the journal The Lancet Neurology.

Jeffrey Bazarian, a professor at the University of Rochester Medical Center, is one of the lead authors of a study demonstrating the effectiveness of a blood test in detecting brain injury.
Credit Emily Boynton / University of Rochester Medical Center

The new test looks for certain telltale proteins that enter the bloodstream after a traumatic brain injury. Jeffrey Bazarian, a professor of emergency medicine and neurology at URMC and a lead author of the study, said the blood test promises to reduce the need for CT scans of the head, which he said have been the “gold standard” of brain injury detection.

Those scans are one of the few ways doctors have of seeing inside the head, Bazarian said. An opening in the blood-brain barrier, which happens as a result of a traumatic injury, offers another. “It’s usually closed,” Bazarian said of the barrier, “but a blow opens it up, which is lucky for us because it allows us to have a brief window into what’s happening in the brain.”

CT scans are expensive, tie up hospital resources, and expose patients to unnecessary radiation, Bazarian said. While the new test he studied is not designed to replace those scans, it can rule them out when they’re unnecessary. If the blood test is negative, Bazarian said, it indicates a CT scan is not needed.

The Food and Drug Administration fast-tracked the blood test for approval through a program the agency says prioritizes tests and treatments that “fill an unmet medical need.”

But the path to this test dates back to 1980s, Bazarian said, when a doctor in Germany half a mile from the Oktoberfest grounds received an influx of intoxicated tourists who suspected head injuries from their reveling but could not speak German to describe their symptoms.

The hospital could not offer CT scans to all the patients, so by necessity, Bazarian said, they tested for proteins in the blood that could indicate a traumatic brain injury. Related tests have incrementally made their way to the U.S.

The study’s conclusions are not without doubt, though. “Our interpretation is that the added value of the test in clinical practice might well be small or even absent,” European researchers wrote in an accompanying commentary that ran alongside the study in The Lancet Neurology.

The test might not change much in European emergency departments, Bazarian acknowledged, but as the first test of its kind in the U.S., he said he expects it to speed up detection of traumatic brain injuries and reduce the burden presented by CT scans.