Soon, a bedside blood test could help detect brain injury, ensure timely treatment

Doctors may soon be able to diagnose brain injury through a bedside blood test even in the absence of CT scan or MRI facilities. This will be especially helpful for doctors at smaller hospitals in the city to diagnose patients quickly and refer them to centres that can treat such patients.

The bedside blood test, being developed by doctors from the All India Institute of Medical Sciences (AIIMS), Delhi, will come in handy for the several government hospitals that do not have specialised imaging facilities available round the clock. The test can help in triaging patients and sending them directly to a higher centre that can manage the symptoms depending on the severity of the injury.

“In cases of traumatic brain injury, the mortality rate is 35% in the first 48 hours. Of those who survive, 50% go slip into a vegetative state and the rest sustain some neurological deficit. These numbers are despite best possible care. So prevention is the best way when it comes to brain injury. But in case there is an injury, it needs to be detected fast,” said Dr Sanjeev Bhoi, professor of emergency medicine, AIIMS trauma centre.

As per data provided by the National Crime Records Bureau, an estimated 1.5 million people suffer from traumatic brain injury every year in India. Of them, 60% sustain injuries due to road accident, 20-25% sustain injuries from falls and 10% due to violence.

Doctors from AIIMS’ trauma centre — which receives the highest share of the city’s casualty — are looking at a serum called Human ubiquitin C-terminal hydrolase (UCHL1), which is a well-accepted biomarker for traumatic brain injury.

The doctors, in collaboration with Indian Institute of Technology (IIT), Hyderabad, have developed the bedside test using gold nanoparticles to detect the serum level in the patient’s blood and diagnose the severity of the brain injury

“For the study, we enrolled patients who came in with traumatic brain injury and performed the necessary scans along with the test. This helped us in comparing the results to see whether the test is as accurate as radio-diagnosis tools. So far, the results have been promising,” said Dr Bhoi.

“However, this was a small pilot study in just our centre. A multi-centric study with a large number of participants would be needed to prove the effectiveness of the test,” he said.

According to an article on the issue recently published in the international journal Analyst, the bedside test is as accurate as the conventional ELISA test – known to be the best for detecting a substance in a sample. It is, the article states, in fact, much quicker. The research paper also maintains that the sensitivity and the specificity of the test is 100%, and can accurately predict mild, moderate, severe brain injury.

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