AACC’s journal highlights new clinical tests that could improve care for concussions

Reviewed by Kate Anderton, B.Sc. (Editor)Jan 6 2020

In a special brain health collection, AACC's The Journal of Applied Laboratory Medicine highlights the innovative clinical tests that laboratory medicine experts are developing to improve care for concussions.

More than 2.8 million Americans present to the emergency department annually with traumatic brain injuries, the vast majority of which are concussions. Even though concussions lie at the mildest end of the traumatic brain injury spectrum, they still lead to a wide range of complications, such as depression, seizures, and even death. This is partly because concussions, with their widely varying symptoms, are the most challenging form of traumatic brain injury to diagnose. In addition to examining a patient's symptoms, clinicians must oftentimes look at results from neurological exams, cognitive tests, and imaging scans to identify this condition. As intensive as this process is, it doesn't always yield clear diagnoses, and it can pull resources away from concussion patients with the most severe cases. Laboratory medicine experts are therefore striving to develop clinical tests that would simplify the diagnostic process for concussions, thereby enabling timelier and more targeted interventions for head trauma patients.

This special collection of The Journal of Applied Laboratory Medicine features research on one such test for concussion, a blood test that accurately identifies elderly concussion patients who do not have brain tissue damage. This test could greatly improve triage for elderly concussion patients, enabling clinicians to focus on cases that require urgent treatment such as surgery. This test was also previously validated for use in younger adults, and when this earlier research came out, a popular misconception arose that the test could determine whether it was safe for an athlete to return to play after receiving blunt head trauma. A review in this special collection seeks to educate consumers on why a triage test-;as important as it is-;can't be used for this purpose, and provides expert insight into the search for a blood test that could diagnose concussed athletes on the field.

Concussion patients represent a heterogeneous population, including older adults, young athletes, and small children. Diagnosing and treating these very different patients poses a diagnostic challenge for physicians, who must quickly decide whether to pursue imaging, whether to escalate care, as well as when to discharge and to advise 'return to play. As a result, many biomarkers have been investigated, from decision-support scales to imaging to blood biomarkers."

Leslie M. Shaw, PhD, review author, University of Pennsylvania Perelman School of Medicine in Philadelphia