STEP 2: Concussion Live Course - November 5-6, 2024, in San Diego, CA-Concussion Diagnosis: Biomarkers and Emerging Technology

Pdf Summary

The document, authored by Ross D. Zafonte, discusses advancements in concussion diagnosis, focusing on biomarkers and emerging technologies. It highlights the need to understand concussion pathophysiology, the role of biomarkers, and new technologies in managing concussions. Biomarkers such as UCH-L1, GFAP, S100B, NF-L, P-tau, and neuron-specific enolase (NSE) are examined for their potential in aiding diagnosis and management. <br /><br />Currently, biomarkers like UCH-L1 and GFAP aid in determining the necessity of CT scans, while countries like Germany and Sweden use S100B for mild traumatic brain injury (TBI) screening. Molecular markers such as MiRNA, particularly those found in saliva, show promise for concussion diagnosis as they remain altered for up to two weeks post-injury.<br /><br />Emerging imaging techniques are also explored. These include advanced neuroimaging like diffusion tensor imaging (DTI), functional MRI (fMRI), and positron emission tomography (PET), which are being refined to improve detection and characterization of concussions. Some methods, like susceptibility-weighted imaging (SWI) and neurite orientation dispersion and density imaging (NODDI), help in identifying microstructural brain alterations resulting from repetitive brain trauma.<br /><br />Limitations in current research include variability among biomarkers, effects of age, gender differences, and increased biomarker levels with physical exertion. Many studies focus on sports-related injuries, and more clarity is needed on biomarker performance in pediatric patients.<br /><br />While not yet standard in clinical practice, plasma biomarkers and advanced imaging technologies hold potential for inclusion in new criteria for assessing concussion severity and could aid significantly in diagnosing and managing concussions. The document underlines the importance of further research to refine these tools for more widespread clinical use.

Asset Subtitle

Ross D. Zafonte, DO

Keywords

concussion diagnosis

biomarkers

emerging technologies

UCH-L1

GFAP

neuroimaging

diffusion tensor imaging

functional MRI

mild traumatic brain injury

concussion management