METHODOLOGY FOR THE DISCOVERY OF NON-INVASIVE BIOMARKERS IN TRAUMATIC BRAIN INJURY

Traumatic brain injury (TBI) is the most common cause of cognitive and behavioral deficits in the U.S and worldwide. Most TBIs are classified as mild-TBI and concussion (C) that are associated with minor symptoms and microscopic damage with no observable pathology on imaging scans, and thus are challenging to be diagnosed. Equally important are asymptomatic sub-concussive (SC) head exposures that when left undiagnosed put the subjects at higher risk of repeated exposures, resulting in cognitive declines and initiation of chronic neurodegenerative disease. C/SC head exposures cause cellular disruptions in the brain which initiate a variety of neuroinflammations and metabolomic dysregulations which have shown to be reflected in variety of biofluids. Recently two blood biomarkers have been approved by FDA for diagnosis of TBI. While minimally invasive blood biomarkers are valuable in diagnosis of concussions, they are less practical in SC exposures in sports and military settings where the rates of the SC are high. Exhaled breath (EB), which expresses various metabolites, proteins, and cytokines, can be a non-invasive alternative approach for these settings. Although EB has recently joined blood and urine as primary biofluids for diagnostic of different diseases like cancer, diabetes and tuberculous; It has not been yet been explored for diagnosis of TBI.