A method for detecting traumatic brain injury at the point of care has been developed by scientists at the University of Birmingham. Using chemical biomarkers released by the brain immediately after a head injury occurs, researchers are able to pinpoint when patients need urgent medical attention.
Immediately after a head injury occurs, the brain releases chemical biomarkers that can be used to pinpoint when patients need urgent medical attention. This saves time in delivering vital treatment and avoids patients undergoing unnecessary tests where no injury has occurred. Using this technique, researchers are able to identify which patients need immediate medical attention and which can be safely discharged. In addition, this approach can be used to monitor patients for deterioration after they have been discharged from the hospital. As a result, the use of chemical biomarkers provides a valuable tool for ensuring that patients receive the best possible care after a head injury.
The technique was developed by a multi-disciplinary team of researchers in the group of Advanced Nanomaterials, Structures, and Applications (ANMSA) led by Dr Goldberg Oppenheimer at the University of Birmingham.
Following a proof-of-concept study, the group has now completed Innovate UK’s commercialisation programme, iCURE, to identify commercialisation routes for the technique, identifying potential partners across eight countries.
The method works using a spectroscopic technique called surface-enhanced Raman scattering, in which a beam of light is ‘fired’ at the biomarker. The biomarker, taken from a pinprick blood sample, is prepared by being inserted into a special optofluidic chip, where the blood plasma is separated and flows over a highly specialised surface. The light causes the biomarker to vibrate or rotate and this movement can be measured, giving an accurate indication of the level of injury that has occurred.
To produce the level of accuracy required, the test needs to be extremely sensitive, rapid, and specific and this is where the Biomedical Engineering expertise at the ANMSA group at the University of Birmingham comes to the fore. The key to sensitivity is in the way the biomarkers interact with the surface. The team developed a low-cost platform, made from polymer and covered with a thin film of gold. This structure is then subjected to a strong electric field, which redistributes the film into a distinctive pattern, optimised to resonate in exactly the right way with the light beam.
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, and the number of people affected is only increasing. According to the charity Headway, around 1 million people each year will visit A&E following a head injury. Current methods of assessing TBI frequently rely on the Glasgow Coma Scale, in which clinicians make a subjective judgement based on the patient’s ability to open their eyes, their verbal responses, and their ability to move in response to an instruction. However, this scale is far from perfect, and many patients who do not meet the criteria for a TBI are nonetheless left with lifelong impairments. In addition, there is currently no agreed-upon definition of what constitutes a “mild” TBI, making it difficult to compare different studies and develop effective treatments. With the number of people affected by TBI only set to increase, there is an urgent need for more reliable methods of assessment and more research into this debilitating condition.
Dr. Pola Goldberg Oppenheimer, a lead researcher on the study, said: “This is a relatively straightforward and quick technique that offers a low-cost, but highly accurate way of assessing traumatic brain injury which up until now has not been possible.
“The current tools we use to diagnose TBI are really quite old fashioned, and rely on the subjective judgement of the paramedic or the emergency doctors. There’s an urgent need for new technology in this area to enable us to offer the right treatment for the patient, and also to avoid expensive and time-consuming tests for patients where there is no TBI.”
Research demonstrating the technique was published in the journal Nature Biomedical Engineering. In the study, 48 patients were assessed using the engineered device, with 139 samples taken from patients with TBI and 82 from a control group. The study showed that in the TBI group, the levels of the biomarker were around five times higher than in samples taken from the control group. The team also found the levels tailed off rapidly around one hour after the injury occurred, further highlighting the need for rapid detection.
The Royal Academy of Engineering has provided additional funding for a market analysis of the need for a new type of technology. The market analysis includes professionals such as paramedics, neurosurgeons, and sports therapists. The market analysis has confirmed that there is indeed a strong need for this new technology. This new technology will help to improve the quality of care for patients, as well as the efficiency of care delivery. There are many benefits to this new technology, and it is clear that there is a strong demand for it. With this additional funding, the development of this new technology can move forward quickly and effectively.
The next stage for this research will be to miniaturise the device technology used to analyse the samples, so that it could be easily stored onboard an ambulance for use by paramedics, used at sporting events where head injuries can be hard to detect, at local GP services or in hospitals where it could be used over time to monitor patients to see how the head injury is progressing. The team is working towards optimising and trailing a prototype technology on a larger patient cohort.
Reposted from Med-Tech Innovation News