“Attractive” Biomarker Identified for Diagnosing Brain Injury

Finding a quick, efficient and objective way to diagnose traumatic brain injury is one of the advances medical science continues to strive for. A goal that would have particular value in combat sports. A recent study published in the journal Neurology identifies a biomarker which is promising in reaching this goal.

In the recent study, titled von Willebrand Factor (vWF) as a Biomarker of Traumatic Brain Injury (4717), the authors looked to whether the vWF Biomarker (a multimeric glycoprotein present in blood plasma) was useful in potentially identifying traumatic brain injury and found that it was indeed an ‘attractive’ marker.

In the study the authors measured vWF in a group of 17 professional boxers. They did so before and after their bouts. The researchers found that vWF levels were increased 1.8 times from pre bout levels following the fights. They comparied this data to vWF levels in patients attending hospital in traumatic brain injury contrasted with uninjured cohorts and found that in brain injured patients vWF levels were elevated compared to the control group.

The full study abstract reads as follows:

Objective: To demonstrate the utility of vWF as a biomarker of TBI

Background: Approximately 13.5 million individuals in the U.S. face disability secondary to traumatic brain injury (TBI). Some of the major long-term sequelae of TBI are significant cognitive dysfunction and up to 2–3 times the risk of developing late-life dementia. The endothelial cell-derived vWF has been recognized as a biomarker cerebrovascular pathology and increased expression has been linked to both vascular and neurodegenerative forms of dementia.

Design/Methods: We have measured the levels of plasma vWF in a cohort of 17 professional boxers (age 18–35, RPQ-3 score ≥1 and ≥ 25 blows to the head) both before and after boxing bouts. In addition, we have compared this data to the levels of plasma vWF in patients presenting to the University of Pennsylvania Trauma Center with TBI (n=42) vs uninjured controls (n=23).

Results: Following boxing bouts, there is a 1.8 fold increase in vWF levels within 30 minutes (p < 0.0009). Moreover, fold-change in vWF correlates moderately (r= 0.51; p= 0.03) with the number of head blows. We also found a positive correlation (r= 0.69; p= 0.002) between fold-changes in vWF and self-reported post-concussive symptoms, measured by the RPQ-3. In hospitalized TBI patients, we found a significant increase in serum vWF levels (mean ± SD: 73.2 ± 31.5 mg/mL) as compared to a control population (40.8 ± 12.4 mg/mL, p<0.0001).

Conclusions: Our data support the use of plasma vWF levels as biomarkers of TBI, which is sensitive to injury severity. Given the known role of vWF in microthromobosis, it represents an attractive candidate biomarker for traumatic microvascular injury.

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