BRAIN-FIRST blood biomarker trial: The arrival of a new “biological witness”?
The East Anglian Air Ambulance (EAAA) is conducting a UK first trial using a handheld blood analyser to detect brain specific biomarkers at the scene. This minimally invasive test provides results within approximately 15 minutes, without the need for laboratory facilities, enabling crews to identify potential intracranial haemorrhage at a much earlier stage.
By supporting rapid on scene assessment and facilitating direct transfer to specialist centres, BRAIN-FIRST has the potential to improve clinical outcomes significantly. It could be particularly valuable in cases involving mild traumatic brain injury, where symptoms are often subtle and can be difficult to distinguish in the immediate aftermath of polytrauma, resulting in those patients potentially receiving effective treatment for brain injury much quicker.
Whilst this wouldn’t rule out Diffuse Axonal Injury (DAI), it should provide far more clarity than the currently objective and rather blunt tool of Glasgow Coma Score (GCS). There has been no indication of if or when a national rollout will take place as the EAAA are still determining if it is feasible to perform the tests in flight. One thing which is currently unclear is whether a national roll out would incorporate road ambulance crew, with air ambulances generally being reserved for those whose injuries are considered more severe.
For the time being, it is important to bear the existence of BRAIN-FIRST in mind. In any incident attended by EAAA, the results should be requested as a matter of course.
CAQK Peptide: Non-invasive drug for treatment of acute TBI
An international research team has identified a tiny peptide, CAQK, that can be delivered intravenously which binds directly to injured brain tissue. In animal models (mice and pigs), it was shown to reduce inflammation and cell death with improved memory, motor function and overall functional recovery.
There is currently no clear timeline for human trials, with researchers "preparing to move towards early human clinical trials" subject to regulatory approval.
Once human clinical trials are approved, it will be important to assess whether the drug is as effective for more severely brain injured patients, or whether it is a drug that should be targeted at mild-moderate brain injuries.
If approved, the presence of a prescribable drug that can assist with recovery from TBI could have potentially huge implications on brain injury claims. When something sounds too good to be true, it often is but this is something insurers will want to keep a very close eye on.
Psychedelic-assisted treatment for TBI-related PTSD and mood disorders
Stanford Medicine has reported that Ibogaine, a psychoactive compound, has been associated with improvements in PTSD, anxiety, depression and cognitive functioning. A clinical trial conducted in Mexico identified improvements in 30 elite military veterans with a history of traumatic brain injury. It is however important to bear in mind that the patients were all highly motivated and high functioning pre-injury, and treatment involved extensive coaching and preparation.
Ibogaine’s current legal status in the UK, and much of the rest of the world, is that of an unlicensed, experimental medication. It can cause fatal heart arrhythmias, and the study used magnesium to shield the heart. However, the future of Ibogaine clinical trials looks promising due to growing interest in the medical community with clinical trials of the drug ongoing.
What’s next?
Whilst 2026 is unlikely to see any of these being implemented into common practice, there are positive signs of scientific innovation and practical developments aimed at better diagnosing and treating TBIs. This is something DWF’s traumatic brain injury group will be keeping under close review, and further insights will be shared about these and other developments over the course of the year.
Article written by Myles Govan, Solicitor, Major Injury and Casualty
Traumatic Brain Injury Group Lead – Edward Cleary, Director, Major Injury and Casualty
