Knock Out Blood Test

By John E. Hocutt, Jr. MD, The Villages Health®

On Valentine’s Day this year, the FDA authorized the use of a blood test to evaluate mild traumatic brain injury (mTBI), better known as a concussion – the Banyan Brain Trauma Indicator.

Major brain injuries obviously require CT scans, extensive treatment, and possibly surgery. Since there are many degrees of concussion—dazed, “out of it,” brief loss of consciousness, and more severe loss of conscious, the extent of damage to the brain is quite variable and hard to assess. The Glasgow Coma Scale defines 15 different levels of concussion and sorting out the amount of brain harmed is just plain tricky.

Clinicians in emergency rooms and family physician offices have to use careful histories and precise diagnostic examinations to determine which patients need CT scans of the brain, close observation, admission with observation, or even surgery for their head injuries. Because our brains are so complex, making this assessment can be hard.

Even more difficult is judging how long to limit and eventually progress physical and mental activity in a concussed patient in order to maximize brain recovery and minimize long-term damage to memory.

Significant concussions and head injuries are associated with an increased deposition of amyloid in the brain, which can lead to memory loss and dementia. Bringing the brain back to full activity at the correct pace is very important to improve long-term brain function and minimize amyloid and tau body deposition, which can cause further harm to the brain.

So, the availability of a blood test to determine what level of concussion a person has suffered can direct immediate treatment (CT scan, admission, observation, restricted activity) AND intermediate treatment with a gradual return to full speed.

Things aren’t always as they seem.

A patient resting comfortably in our office can look perfectly normal on a neurological exam after having sustained a significant head injury, causing the clinician to feel comfortable and allowing the patient to return to full activity. But many patients may have sustained cellular damage, releasing damaging proteins in the brain. These proteins can best be removed with minimal harm if the brain is allowed to rest. Watching TV or reading for even an hour can overload a concussed brain, interfering with healing.

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Making an ImPACT!

ImPACT testing can detect deficits in cognitive function. The test results are much more precise with a pre-injury baseline evaluation for comparison. The extent of abnormal results helps the clinician decide how fast to progress the patient’s return to mental and physical activity.

ImPACT testing is mostly done with high school, college, and professional athletes. They are usually the highest risk groups for concussion and are accessible to athletic trainers and physical therapists for baseline testing.

What is ImPACT testing? It’s a 25-minute computerized neurocognitive timed response assessment tool that sets a baseline for sharp mental function. After a significant concussion, the test shows a slowing of mental response. As the test results improve, the patient can safely be more active.

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What’s blood got to do with it?

A blood test measuring the amount of the specific proteins released in brain trauma would be extremely helpful in determining the extent of brain injury and deciding which patients should have an immediate brain CT scan. The level of abnormal protein can be a relatively precise guide for the pace of return to full activity.

Since most adult patients will not have had a baseline ImPACT test, the Banyan blood test can conveniently and reliably give the clinician an accurate assessment of the extent of brain injury.

The practical benefit of a blood test for concussion also means many fewer CT scans would be necessary, saving expense, time, and radiation exposure to patients. Most importantly, it should mean more appropriate care reducing over and under treatment. Hopefully, this will result in fewer problems with memory degradation as patients progress through life.

Coming soon to a lab near you!

LabCorp and Quest Labs report that the Banyan Brain Trauma Indicator blood test will be available for clinical use “soon.”

Hopefully you will never have a head injury. But if you or a family member ever does, be sure to inquire about using this blood test to assess the extent of brain injury and guide your safe return.

 

Last updated: 04.27.2018
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Written byDr. John Hocutt

John E. Hocutt, Jr., MD practices family and sports medicine at The Villages Health Colony Care Center in The Villages®, Florida. He graduated from Jefferson Medical College in Philadelphia, completed his residency at the Medical Center of Delaware, and is certified by the American Board of Family Practice. After more than three decades of practicing medicine, Dr. Hocutt firmly believes that it’s a team sport. “The patient should be an active participant in his or her care. Clear communication and respect are also critical for excellent patient care.” He is a published author, national speaker, dedicated volunteer, and winner of many industry honors, from a “Patient’s Choice” doctor to a “Top Doc” in sports medicine. And how does Dr. Hocutt enjoy his free time? Golf, softball, water skiing, cycling and swimming – you guessed it – sports!

Coach Image

Written by Dr. John Hocutt

John E. Hocutt, Jr., MD practices family and sports medicine at The Villages Health Colony Care Center in The Villages®, Florida. He graduated from Jefferson Medical College in Philadelphia, completed his residency at the Medical Center of Delaware, and is certified by the American Board of Family Practice. After more than three decades of practicing medicine, Dr. Hocutt firmly believes that it’s a team sport. “The patient should be an active participant in his or her care. Clear communication and respect are also critical for excellent patient care.” He is a published author, national speaker, dedicated volunteer, and winner of many industry honors, from a “Patient’s Choice” doctor to a “Top Doc” in sports medicine. And how does Dr. Hocutt enjoy his free time? Golf, softball, water skiing, cycling and swimming – you guessed it – sports!

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Disclaimer: This content is for informational purposes only and it is not meant to be relied on as medical advice, diagnosis, or treatment. Consult your physician before starting any exercise or dietary program or taking any other action respecting your health. In case of a medical emergency, call 911.

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