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Trial Identifies Biomarkers for Quick Concussion Test

Brain activity graphic

(Gordon Johnson, Pixabay)

11 Nov. 2021. A clinical trial reveals glycan compounds found in saliva and urine as indicators of traumatic brain injury, helping create a quick diagnostic for the condition. Results of the trial conducted by Medicortex Finland Oy in Turku, Finland appear Tuesday in the journal Brain Sciences.

Traumatic brain injuries or TBIs such as concussions, result from blows to the head, including those from contact sports, or penetrations of the skull that disrupt normal brain functions. Military service members in combat are particularly vulnerable to TBIs, which often result from improvised explosive devices, such as road-side bombs experienced by U.S. troops and their allies in Iraq and Afghanistan. According to Department of Defense statistics, some 384,000 service members were diagnosed with TBIs since 2000, with more than 8 in 10 (82%) TBIs rated as mild, and the bulk of those injuries suffered by Army soldiers.

As reported by Science & Enterprise in July 2019, Medicortex Finland received DoD funding to develop a prototype test kit to diagnose TBIs. The company’s technology aims to quickly detect biomarkers, or biological indicators, of TBIs in accessible bodily fluids, like saliva or urine. The company says impacts to the head cause changes in the brain’s chemistry. As a result, the trauma also breaks down the blood-brain barrier, allowing characteristic proteins and enzymes indicating brain cell damage to enter the blood stream.

The clinical trial, conducted at Turku University Hospital assessed 23 adult participants, 11 individuals diagnosed with TBI and 12 healthy persons for comparison, mainly hospital staff. All participants provided blood, saliva, and urine samples, while those with suspected head trauma also received computed tomography or CT scans to confirm the extent of their injuries. The authors from Medicortex Finland and Turku Hospital point out that participants with head trauma were primarily men and with an average age of 64, older than the working-age healthy participants.

Glycans released from brain tissue

Researchers analyzed the samples for compounds binding to lectins, natural plant proteins with an affinity for carbohydrates. In this case, the team focused on glycans, a type of carbohydrate in proteins that ranges from simple to complex in structure. Glycans, say the authors, are released from nerve tissue in the brain when a patient suffers a TBI, and the blood–brain barrier is damaged.

Of the 11 participants with head trauma, nine individuals were diagnosed with mild injuries and two with severe injuries. Among those with head trauma, saliva samples show higher concentrations of one glycan compound than non-injured participants, while urine samples indicate higher concentrations of another glycan and lower rates for two separate glycans. At the same time, blood samples show lower concentrations of two other glycan compounds in plasma among those with head trauma, compared to healthy participants.

The higher rates of identifiable glycans in saliva and urine, say the researchers, can help speed development of a quick diagnostic test for TBI, particularly mild cases such as concussions that may otherwise go undetected. The authors note a rapid TBI test …

facilitates decision making when the test results are easily available with a low cost. It gives additional value and strengthens the validity of the clinical assessment. If the test is sensitive enough, it may diminish the need for a head CT scan. Such examinations are only available in big clinical centers and may require time-consuming travel and costly procedures.

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