Show notes
Concussion Blood Test & Treatments for CTE, TBI and Brain Impairments
Dr. Michael Lewis - Reports on a blood test for a concussion and what to do about CTE or TBI. The Brain Trauma Indicator Test at Banyan Biomarkers measures two biomarkers: proteins known as UCH-L1 and GFAP, that are released upon injury to the brain and pass through the blood-brain barrier. Elevated levels of these proteins can be detected within 15 or 20 minutes of injury. The test can be taken within 12 hours of injury, and results can be obtained within three or four hours.
Patients are currently diagnosed with concussion based on a combination of symptoms as well as imaging. However, CT scans don't always detect concussion.
"Over 90% of CT scans (for concussion) are negative. And you get 200 times the radiation of a chest X-ray. It's expensive; it's not terrific," said Hank Nordhoff, chairman, and CEO of Banyan Biomarkers, maker of the new test. It can help determine whether a patient further needs a CT scan, based on a physician's concerns.
It's not concussions that cause CTE. It's repeated hits, a study finds.
Second Interview at CBJ on Concussion
Listen up as Dr. Lewis, a West Point-trained Army officer and physician with specific interests in brain injury was a previous excellent CBJ Guest at CBJ/171, details improved diagnosis and treatment for brain injury.
Photo by Aimee Vogelsang on Unsplashcon
Dr. Lewis' Brain-Focused Bio
In late 2011 upon retiring as a Colonel after a distinguished thirty-one-year career in the US Army. His pioneering work in the military and since has helped thousands of people around the world and is regularly featured in the media, including CNN's Sanjay Gupta, MD, show and numerous radio shows and podcasts.
A graduate of the US Military Academy at West Point and Tulane University School of Medicine, Dr. Lewis is board-certified and a fellow of the American Colleges of Preventive Medicine and Nutrition. He completed postgraduate training at Walter Reed Army Medical Center, Johns Hopkins University, and the Walter Reed Army Institute of Research.
He is currently in private practice in Potomac, Maryland (BrainCARE, www.BrainCARE.center); is a consultant to the US Army and Navy as well as several organizations, institutes, and nutrition companies around the world; and is a founding member of the Pop Warner Youth Football Medical Advisory Board.
Ed Note: See his book give away offer below↓, open until June 20, '18
Concussion Testing Details - Radiation Exposure Minimized
The US Food and Drug Administration has, for the first time, approved a blood test to help detect concussion in adults.
"Today's action supports the FDA's Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging -- an effort to ensure that each patient is getting the right imaging exam, at the right time, with the right radiation dose," FDA Commissioner Dr. Scott Gottlieb said in a statement Wednesday.
Concussion Diagnostic Costs Reduced
The test could also help reduce costs significantly. Whereas a CT scan can cost $800 to $1,500, Nordhoff predicts that the new test would cost closer to $150.
The test would be available to hospitals, Nordhoff said, and he hopes a handheld sideline device could be commercially available in the near future.
The Concussion - Subconcussion Study
The FDA approved the test as part of its Breakthrough Devices program after evaluating a clinical study of 1,900 blood samples from people thought to have a concussion or mild traumatic brain injury. The clinical trials did not include any children, though Banyan plans to include them in future studies.
When compared with a CT scan, the blood test was 97.5% as effective in detecting concussion and 99.6% effective in ruling out a concussion.
"A blood test that accurately, reliably and consistently detects the presence of brain proteins that appear in the blood after a brain injury is a major advance," said Dr. David Dodick, a fellow of the American Academy of Neurology who specializes in sports medicine and neurology. He was not involved in the development of the test.
Though Dodick was optimistic about the blood test, he said a lot of work still needs to be done in understanding and diagnosing brain injury. He pointed out that we need better measurements to understand when brains have fully healed from trauma, as well as a better understanding of how these biomarkers act which may actually affect prognosis.
It's also unknown how this test can determine subconcussive hits, "hits that don't cause symptoms but do cause a brain injury," he explained. "These occur much more often than actual concussions, especially in certain collision and contact sports."
Note: Subconcussive or repeated hits to the head are believed to be the root of the neurodegenerative disease chronic traumatic encephalopathy or CTE.
In fact, Banyan has partnered with another company, Quanterix, to help develop a test that could eventually detect the impact of repeated hits. Quanterix aims to combine the biomarkers with Banyan with digital technology that can look at the proteins at a super-microscopic level and pinpoint low-level concentrations of the proteins.
"The key now is to use this sensitivity to evolve in more brain health and to protect athletes and keep soldiers out of harm's way," said Kevin Hrusovsky, president, and CEO of Quanterix.
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This Report From CNN: See the latest news and share your comments with CNN Health on Facebook and Twitter, linked below.
Dr. Gupta Weighs In on Concussion and CTE
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The FDA Considers A New Approach To Diagnosis for Concussion
The FDA believes that using the new blood test, imaging can be avoided in at least a third of patients who are suspected of having a concussion.
Stats on Brain Injury - 2.8M!
According to the US Centers for Disease Control and Prevention, there were approximately 2.8 million incidents involving traumatic brain injury emergency department visits, hospitalizations and deaths in 2013.
[spp-tweet tweet="#Concussion #CTE #TBI now understood through a new #bloodtest approved by the FDA Details & Video http://corebrainjournal.com/224"]
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Enter Drawing For 2 of His Books
When Brains Collide
HERE - Closes June 20, 2018
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Treatment Links and References, Amended 6-2-18
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Multiple Additional CBJ Experts on TBI, CTE
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Thanks
Thanks, Dr. Lewis, for joining us here at CBJ to review these personal observations about your useful insights on the evolution of self-management.
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Our Next CoreBrain Journal Episode
224 Corinne Zupko, a licensed counselor and Mindfulness-Based Stress Reduction teacher, undertook her study of psychology out of necessity when debilitating anxiety threatened to derail her life. Seeking ways to do more than temporarily alleviate her symptoms, Corinne began to study A Course in Miracles (ACIM), mindfulness meditation, and the latest therapeutic approaches for treating anxiety.
As Corinne healed her own mental anguish, she compiled the perception-shifting process she describes in her book: From Anxiety to Love: A Radical New Approach for Letting Go of Fear and Finding Lasting Peace(New World Library, February 14, 2018).
From Anxiety to Love helps readers learn to undo anxiety-based thinking by internalizing the teachings of ACIM, fostering mindful shifts in their thoughts and actions, and connecting to their Inner Therapist, the deeply gratifying, enormously comforting inner voice that affirms our safe oneness with the universe rather than our ego's perception of danger and separation. Whether struggling with everyday stress or near-crippling discomfort, readers will find that Corinne's approach offers a new way of healing from — rather than just coping with — fear and anxiety.
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