Scientists at the University of Birmingham have developed a method for detecting traumatic brain injury - or TBI - at the point of care.
Using chemical biomarkers released by the brain immediately after a head injury occurs, researchers can determine when patients need urgent medical attention, meaning vital treatment is delivered sooner and patients avoid undergoing unnecessary tests where no injury has occurred.
The technique was developed by multi-disciplinary team of researchers, led by Dr Pola Goldberg Oppenheimer, from the group of Advanced Nanomaterials, Structures and Applications (ANMSA) at the University of Birmingham.
How does it work?
According to the University of Birmingham’s website:
“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 pin prick 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.”
Leader of the research group, Dr Goldberg Oppenheimer, explains: “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 Traumatic Brain Injury 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.”
At present, methods of assessing a traumatic brain injury often rely on the Glasgow Coma Scale. Clinician will 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.
Research demonstrating the new technique was published in the Nature Biomedical Engineering journal. The study involved 48 patients who were each assessed using the engineered device, with 139 samples taken from patients with traumatic brain inury and a further 82 from a control group.
Within the TBI group, the study showed the levels of the biomarker were around 5 times higher than in the control group’s samples. Researchers also found the levels of biomarker reduced rapidly around 60 minutes after the injury took place, further highlighting the need for rapid detection.
Extra funding from the Royal Academy of Engineering also enabled a market analysis - involving paramedics, neurosurgeons and sports therapists – to take place, which has confirmed a strong need for the new technology.
The researchers have now identified commercialisation routes for the technique following a proof-of-concept study and completion of Innovate UK’s commercialisation programme. Potential commercial partners have been identified across a total of eight countries.
The next stage of this research will be to scale down the device technology used to analyse the samples, so that it may be stored in ambulances, for use at sporting events where head injuries can be hard to detect, and at local GP services or hospitals where it could be used over time to monitor how a patient’s head injury progresses. The team is working towards optimising and trailing a prototype technology on a larger patient cohort.
"The work which is being done at the University of Birmingham is exciting and could prove to not only be a more efficient and cost-effective way of diagnosing traumatic brain injury, but also lead to significant improvements in the outcome for patients who have suffered a head injury. Early diagnosis should lead to more prompt treatment, which will reduce the incidence of long-term complications and death.
Whilst research into faster diagnostic techniques has been ongoing for years, in a real life emergency situation medical practitioners are still having to rely on the traditional methods of diagnosis such as clinical assessment, scans and lumbar punctures. Valuable time can easily be lost as the medics take the normal investigative steps and, as a consequence, the window in which deterioration could be stemmed is sometimes lost. Therefore, any easy, non-invasive and readily available method for early diagnosis of TBI will be an excellent tool for the medical team in an emergency setting and a potential life-saver for the patient."
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