Blood test could take the guesswork out of concussions

Medical Watch
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A portable, rapid blood test to detect concussion. It sounds like science fiction, but it’s in development now. And it takes the guesswork out of diagnosis.

It’s like a portable laboratory – a handheld device developed by healthcare company Abbott. A few drops of blood on a cartridge and the i-Stat goes to work. Within minutes, the rapid blood analyzer can measure a range of organ functions and blood gases. The results help nurses and doctors make treatment decisions – right at the bedside. It does the same on the battlefield – military medics use the device to help assess injured soldiers.

But the Department of Defense has another idea in mind for the diagnostic tool – they’ve asked Abbott to develop a new cartridge capable of detecting specific biomarkers associated with concussion or mild traumatic brain injury (TBI).

Dr. Beth McQuiston, Abbott Medical Director and Neurologist: “When you cause damage to the brain, markers come out that you can then measure. And you can measure those with two or three drops of blood.”

Jim Stewart, Abbott Diagnostics Research Director: “Each of those little gold spots is a chip that goes in the cartridge.”

They print them in bulk — tiny chips designed to detect and analyze the specific concussion markers.

Jim Stewart: “Basically the protein is there. It can be seen, and now our challenge is to see how far we can push that.”

Hundreds of test cartridges come down the assembly belt each day – at the end the experimental chips are dropped in.

Jim Stewart: “The chip contains a biological component, an antibody that will recognize the TBI protein.”

Dr. McQuiston: “The problem we’re having with mild TBI is it’s not always clear. You’re not sure if someone has had a concussion.”

Concussion is a clear threat in combat. Staff Sergeant Matthew Ritenour served two years – leading his squad along the frontlines in southern Afghanistan.

Staff Sergeant Matthew Ritenour: “I’ve known guys who have had blast trauma and ended up having brain damage because of it, even though they didn’t have to be medevaced and they didn’t lose a limb. It still did damage to their brains.”

He says a definitive concussion test could be helpful … in the right situation.

Staff Sergeant Ritenour” “If you’re in combat, down range, sometimes you can’t sit a guy out. It doesn’t work like that. But in training, if you know someone has a brain injury and they just need to rest, let their brain heal, it’s definitely beneficial.”

But the test has the potential to make an impact beyond the battlefield.

Dr. McQuiston: “If you look at high school students or college students playing competitive sports, the majority of time these athletes do not lose consciousness when they have a concussion.”

During Hunter Hillenmeyer’s eight-year career with the Chicago Bears, the linebacker suffered five documented concussions. In college there was one, as well, and another during his high school days.

Hunter Hillenmeyer, former Chicago Bears Linebacker: “I played from 2003 to 2010 and even in that time period the attitude around what a concussion is — treating them, diagnosing them, return to play guidelines — all changed dramatically. I had a concussion in 2004, my first in the NFL, and I went right back in. I played the entire second half with very little memory of the game, and that would never happen today.”

And if the concussion test makes its way to the sidelines, youth and professional sports could change dramatically. But Hunter is hopeful the research will continue toward treatment.

Hunter Hillenmeyer: “The diagnosis of concussions is just one piece of it, but if they’re getting to the level where they know a specific protein is released upon impact, they’re getting closer to figuring out some of the metabolic changes that might happen at the tissue level where there will eventually be treatments. That’s where my mind is going. When do we get towards treatment and solutions, because the diagnosis of concussion is just one very small piece of the puzzle.”

Concussion and mild traumatic brain injuries are a staggering problem in the United States – approximately four concussions occur every minute. The CDC puts the cost at 77 billion dollars a year.

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