Locally owned and independent
October 19, 2023
The Northern Rivers Times
HEALTH & SENIORS NEWS 45
New blood test could improve concussion diagnosis: study Monash University A global blood test for concussion could be a step closer after a Monash University-led study discovered specific proteins or biomarkers that can help diagnose concussions relatively quickly and accurately. Once approved, a blood test identifying these biomarkers could improve the diagnostic process of concussion following accidents, sport-related collisions, or other injuries, aiding management and recovery. It would be used alongside, rather than replace existing diagnostic measures such as physical signs and symptom selfreporting, to improve accuracy. There is no blood test approved globally for concussion, also known as mild traumatic brain injury. While a CT scan can be used to detect a brain bleed after concussion, most concussions do not result in brain haemorrhage. Published in Neurology®, the new study looked at four protein biomarkers. The collaborative study between Monash University researchers and
The Alfred Emergency Department (ED) clinicians discovered that blood levels of three proteins, each reflecting different aspects of the biology of brain trauma, provided precision in classifying concussion for patients under the age of 50 who present to an ED within six hours of injury. When the inflammatory biomarker, interleukin 6 or IL-6, was measured alongside glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1), two proteins exclusive to the brain, this combination showed incredible sensitivity and specificity in distinguishing individuals with concussion from those without. Study lead and Monash Trauma Group
Principal Investigator Dr Stuart McDonald said accurate diagnosis of concussion was often difficult as clinicians rely on symptoms, often self-reported, or tools like imaging that lacked sensitivity to this form of brain injury. “Concussion diagnosis is notoriously challenging in many cases because clinicians rely on subjective observations of physical signs and self-reported symptoms, neither of which are specific to concussion and often exhibit subtlety and rapid evolution,” Dr McDonald said. “Consequently, even in the ED, individuals can be discharged without a definitive diagnosis. Our findings showed that the panel of biomarkers we assessed performed really
well even in patients that lacked the more overt signs of concussion, such as loss of consciousness or post-traumatic amnesia.” Co-study lead and Monash University Professor Biswadev Mitra, who is Director of Emergency Medicine Research at The Alfred, said if further research validated these results and biomarkers were granted regulatory approval in Australia, they could increase diagnosis certainty not just for clinicians but for patients too, enabling earlier management. “Within the ED, we believe the test might prove useful in providing certainty in difficult-toassess cases, especially when a patient may be unwilling or unable to communicate their
symptoms,” Professor Mitra said. “One example could be in cases of domestic violence, where the test might reveal a mild brain injury that could otherwise go unnoticed.” Dr McDonald said the test had great potential to help manage sports concussion. “While at this stage it may not be feasible to conduct a test that alters decisions within a match, players with a potential or suspected concussion that are removed from play could feasibly be tested soon after the match, with a more definitive diagnosis helping with many aspects of the player’s recovery and return to play process,” he said. “Given concussion remains a clinical
diagnosis, the best clinical assessments and patient care are likely in the ED setting. Nevertheless, there is potential for this test to be applied beyond the hospital setting in the near future.” The project also identified another biomarker that could help in diagnosis much later after a concussion. In the same patients studied a week after their concussion, the researchers found another brain specific biomarker, neurofilament light (NfL), was elevated in blood and had comparable diagnostic properties as the acute markers. Dr McDonald said this suggested NfL could be particularly suited for assisting concussion diagnosis in cases of delayed assessments. “Beyond the ED, measures of blood NfL may be most beneficial when individuals consult a GP multiple days after an impact, especially in situations where diagnostic certainty is crucial for making safe return-to-work or returnto-play decisions, such as in military or sports settings,” Dr McDonald said.
Largest ever study on light exposure proves its impact on mental health Monash University The world’s largest study on light exposure and its impact on mental health, with almost 87,000 participants, has found that increased exposure to light at night increases a person’s risk for psychiatric disorders such as anxiety, bipolar and PTSD severity as well as selfharm. Importantly, the study also found that increasing exposure to daytime light can act like a non-pharmacological
means for reducing psychosis risk. In those exposed to high amounts of light at night, the risk of depression increased by 30 per cent – while those who were exposed to high amounts of light during the day reduced their risk of depression by 20 per cent. Similar patterns of results were seen for self-harm behaviour, psychosis, bipolar disorder, Generalised Anxiety Disorder, and PTSD. These findings indicate
that the simple practise of avoiding light at night and seeking brighter light during the day could be an effective, non-pharmacological means of reducing serious mental health issues. The study, led by Associate Professor Sean Cain, from the Monash School of Psychological Sciences and the Turner Institute for Brain and Mental Health in Melbourne, Australia, is published today in the journal, Nature Mental Health. “Our findings will have a potentially huge societal impact,” said Associate Professor Cain. “Once people understand that their light exposure patterns have a powerful influence on their mental health, they can take
some simple steps to optimise their wellbeing. It’s about getting bright light in the day and darkness at night.” The study’s 86,772 participants were all from the UK Biobank, and were examined for their exposure to light, sleep, physical activity and mental health. Associate Professor Cain said the impact of night light exposure was also independent of demographic, physical activity, season and employment. “And our findings were consistent when accounting for shiftwork, sleep, urban versus rural living and cardiometabolic health,” he said. Humans in modern, industrialised times have literally turned our biological systems upside down. According
to Associate Professor Cain, our brains evolved to work best with bright light in the day and then with almost no light at night. “Humans today challenge this biology, spending around 90 per
cent of the day indoors under electric lighting which is too dim during the day and too bright at night compared to natural light and dark cycles. It is confusing our bodies and making us unwell,” he said.
