Breath test could diagnose repetitive blast injuries to the brain for first time: Lawson

Scientists at London’s Lawson Health Research Institute say they have developed a way for doctors to accurately diagnose repetitive blast injuries to the brain for the first time, all using a simple breath test.

There is currently no accurate way to test and diagnose a repetitive blast injury, which Lawson researchers describe as a mild traumatic brain injury that results from pressure changes caused by an explosion. Instead, doctors have to rely on a patient’s history and symptoms to make a diagnosis.

This new test, developed with scientists from Defence Research and Development Canada and set to undergo clinical trials in the near future, is considered a world first, and looks for particular blood biomarkers in the breath that can indicate exposure to a blast injury, according to Lawson.

“We went to the Canadian military and we did a collaborative study together, and we found that metabolites in the blood — these are your final breakdown products from your metabolism — that people who had been exposed to repetitive blasts had a very different profile of metabolites in their blood,” said Lawson scientist Dr. Douglas Fraser.

“What was intriguing about these metabolites is a certain number of them are actually expelled in your breath. When you take a deep breath in and then out, that’s how the metabolites actually leave your body.”

Fraser, who is also a professor at Schulich School of Medicine and Dentistry, said the test would mark the first use of a breathalyzer for this kind of screening. Similar to a police alcohol breathalyzer, the person would blow into a straw connected to the device, which would then measure metabolites of interest in the breath sample.

The device would then be able to show whether the individual’s metabolites are good, whether they are getting into a warning zone, or whether they are at risk of developing serious symptoms.

Those at risk for repetitive blast injuries, which Fraser says occur when a pressure wave caused by an explosion is sent through the head and brain, resulting in concussion-like effects, include people in the military and policing, people working in mining, and members of the public in war zones.

“It would be used as a health surveillance device, so if you could imagine going into basic training or entering into a regiment where there’s lots of explosions going on using grenades, mortar sniper fire, even the large bullets create a pressure wave,” Fraser said.

“So if you can imagine screening these individuals at regular basis and then having the device (show) literally a red, green or yellow light,” indicating their metabolite status, he said, adding that if a test shows red, meaning at risk of developing serious symptoms, a followup blood test could be conducted to get an exact answer.

“Along the way, the metabolites are telling us something about what’s going on in the brain and how we might treat it as well. So it appears to us, based on the metabolite pattern, that the brain’s actually in a state of energy deficiency, and some of those problems might be corrected with dietary therapy, with certain types of foods and ingredients.”

After decades of research, Fraser says there is still much that the scientific community does not know about the brain, although he notes that advances in technology have allowed researchers to “tackle some of these bigger problems a little bit more efficiently and understand a little bit more.”

It’s possible that such a breath test could be used for other brain injuries, such as concussions, Fraser said. However, he notes that while the symptoms of a concussion and a repetitive blast injury are similar, the mechanisms of the actual injury itself are different.

In 2016, Fraser and other Lawson researchers developed a blood test to diagnose adolescent concussions in sport. The test, which also involves blood metabolites, is being evaluated by the FDA, Fraser said.

“We should be called upon by the Canadian military to enter clinical trials at any point,” Fraser said of the new breath test. “We’re more or less on standby.

“I look at it that, who do we call upon to protect us during times of conflict and catastrophe? This is our opportunity to protect them a little bit.”

— with files from Devon Peacock