Point-of-Care Blood Biomarker Test Detects Brain Injury Missed by CT

Approximately 2.8 million people in the U.S. experience traumatic brain injury each year, contributing to substantial mortality, morbidity, and long-term disability. Although computed tomography (CT) is widely used for rapid first-line assessment, it can miss some intracranial abnormalities. New findings now suggest that blood-based biomarkers may help clinicians more accurately assess brain injury severity.

Clinician-scientists at the University of Pittsburgh School of Medicine led a multi-institutional team evaluating clinical cutoffs for two brain-associated proteins detected in blood after traumatic brain injury. The test measures glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1), which rise in the bloodstream after brain injury and decline over time. 

The biomarkers are intended to help distinguish patients with mild traumatic brain injury who have positive computed tomography (CT) findings from those with negative scans, including patients whose abnormalities may only be visible on magnetic resonance imaging (MRI).

The study used data and biospecimens collected through TRACK-TBI, a multicenter, longitudinal study of patients with traumatic brain injury presenting to emergency departments. Pitt’s Neurotrauma Clinical Trials Center serves as the primary biorepository for the study. The analysis focused on patients with Glasgow Coma Scale scores of 13 to 15.

Within 24 hours of injury, blood GFAP levels distinguished patients with acute brain injury from those with no evidence of pathology on neuroimaging. GFAP, which is released from glial cells in the brain, showed a sharp increase between four and 20 hours after injury, followed by a slower decline over the next several days. UCH-L1, which is released from neurons, showed less ability to distinguish among the study groups.

The study was published in the Journal of Neurosurgery on October 23, 2026. The article states that a point-of-care, whole-blood version of the test is now available and can be performed at the bedside rather than requiring sample shipment to a laboratory. The researchers are also exploring whether blood biomarkers could help predict long-term outcomes after traumatic brain injury.

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