This Protein Predicts the Future of the Brain After Traumatic Injury


Neil Graham saw multiple head injuries: “Car accidents, violence, assaults, gunshots, stabbings-really work,” says Graham, a neurologist from Imperial College London who practices at St. Mary’s Hospital nearby.

Doctors stop the bleeding, they relieve any increase in pressure inside the skull, they may put the patient in a state of disarray that can prevent the brain from functioning when it needs to rest and heal. It also helps to describe – to a degree. CT or MRI scans focus on lesions or hemorrhage fragments in the gray matter, the outer layer of the brain where neurons do most of their processing. But a clean scan is not a clean bill of health. Trauma to axons-such as nerve-like neuron fibers that move toward other neurons-is often seen in deep white matter, sometimes not detected by simple scans.

Axonal damage is a factor. The tank of cognition and motor function when neurons cannot exchange messages. And if the white object absorbs a blow, the fall not only can it continue, it can get worse, causes severe thinking or movement problems. But doctors don’t always know about that damage. It is difficult then to give those who are confident to save the future. “Families and patients early on ask us, ‘What will it look like in six months or a year? When can I get back to work?'” According to David Sharp, a professor of neurology at Imperial College London who also practices at St.

Sharp and Graham thought they could find the response to proteins, or biomarkers, carried in a person’s blood. They collaborated with trauma experts across Europe for a study that followed nearly 200 patients with a head injury in a year. The researchers tested brain scans, plasma analysis, and white matter samples, tracking how five biomarkers were related to severity of damage-and recovery. in person. In consequences published in September at Medicine in the Translation of Science, they target a specific protein: neurofilament light (NfL). NfL levels increase for weeks after an injury and may continue long for a year later.

Plasma NfL will not tell you emphasis Axonal damage, however, is a quick way to measure damage – and track it over a long period of time – compared to advanced MRI techniques.

“Brain injury, you think of it as an event: Someone is injured and that’s it, they recover or not,” said Richard Sylvester, a neurologist at the National Hospital for Neurology in London who was not involved in the study. . “But we know there’s an ongoing process.”

Biomarkers are valuable symptoms, because it helps doctors focus on pathology rather than symptoms. Symptoms may be vague, based on the patient’s subjective experience. They tell you what the effect of some damage is, not what the actual damage is. Biomarkers, however, can be like molecular receptors that point to specific processes, such as cutting axons.

If a patient has an unexplained symptom such as chest pain, for example, cardiologists may test for biomarkers such as troponins and use that information to differentiate between a heart attack or something less serious. severe, such as gas or a pulled muscle. “You drill. You get a specific pathological diagnosis,” Graham said.



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