Objective Markers for Diagnosing Concussions: Beyond Blood Biomarkers and the Role of Real-Time Diagnostic Tools

Introduction: Concussions, a type of mild traumatic brain injury (mTBI), are often underdiagnosed due to the subjective nature of symptoms and limitations of current diagnostic methods. Clinical evaluations, including tools like the SCAT5, BESS, and VOMS, achieve high sensitivity and specificity but may not capture the full scope of concussive injuries. While blood biomarkers (e.g., GFAP, UCH-L1, tau) and advanced imaging techniques (e.g., DTI, fMRI) are being researched, they are not yet widely accessible or practical for routine diagnosis. This review explores objective markers, combining clinical and biomarker testing, as a potential strategy for more accurate and comprehensive concussion diagnosis and recovery tracking.

Objective: To synthesize current literature on clinical and biomarker-based concussion diagnostics, with a focus on the role of neuroimaging, electrophysiological measures, and real-time diagnostic tools like EEG, alongside traditional clinical evaluations.

Methods: A comprehensive literature review was conducted, examining studies on non-invasive objective markers, clinical tools, and real-time diagnostic approaches for concussion diagnosis.

Results: Objective markers such as advanced neuroimaging (e.g., DTI, fMRI), electrophysiological tools (e.g., EEG, MEG), and clinical evaluations like SCAT5 and VOMS show high diagnostic value. Biomarkers, though promising, are not yet ready for routine clinical use. Combining clinical assessments with advanced imaging or electrophysiological measures offers the potential for more accurate tracking of concussion recovery.

Conclusion : While current clinical evaluations are highly effective, integrating real-time diagnostic tools and biomarkers into clinical practice could improve the precision and timeliness of concussion diagnosis. Further research is necessary to validate these methods and establish standardized protocols.