Although concussion affects an estimated 1.8-3.6 million persons each year, no diagnostic tools exist for evaluating this injury. Evaluation of concussion relies on accurate history taking (which is dependent on patient’s recollection and willingness to provide accurate answers) and physical examination (which is not always reliable). The majority of concussed persons achieve full recovery within 7 days, however, approximately 25% have persistent cognitive deficits that last more than 30 days. Unfortunately, clinicians have no objective tools for predicting how long it will take for a concussed person to recover. Current efforts to identify blood-based biomarkers for predicting protracted recovery from concussion are focused on examining circulating proteins (proteomics). However, the existence of the blood brain barrier (BBB) limits the ability of brain-enriched proteins (which are typically large) to enter the circulatory system. Despite this limitation, a number of brain-enriched proteins including Tau, αII-spectrin N-terminal fragment (SNTF), and neurofilament light chain (NFL) have been reported to have prognostic significance in concussion. However, the prognostic accuracy of these proteins reported in published studies are modest. Therefore innovative approaches are needed for identifying novel blood-based biomarkers of concussion.
