Claim: Researchers identify CTE biomarker that may lead to diagnosis while alive
Verdict: SUPPORTS

Retrieved passages:
title: Chronic traumatic encephalopathy
text: be definitively diagnosed by direct tissue examination after death, including full and immunohistochemical brain analyses. The lack of "in vivo" techniques to show distinct biomarkers for CTE is the reason CTE cannot currently be diagnosed while a person is alive. The only known diagnosis for CTE occurs by studying the brain tissue after death. Concussions are non-structural injuries and do not result in brain bleeding, which is why most concussions cannot be seen on routine neuroimaging tests such as CT or MRI. Acute concussion symptoms (those that occur shortly after an injury) should not be confused with CTE. Differentiating between

title: Biomarker (medicine)
text: biomarker research. Coronary angiography, an invasive procedure requiring catheterization, has long been the gold standard for diagnosing arterial stenosis, but scientists and doctors hope to develop noninvasive techniques. Many believe that cardiac computed tomography (CT) has great potential in this area, but researchers are still attempting to overcome problems related to “calcium blooming,” a phenomenon in which calcium deposits interfere with image resolution. Other intravascular imaging techniques involving magnetic resonance imaging (MRI), optical coherence tomography (OCT), and near infrared spectroscopy are also being investigated. Another new imaging biomarker involves radiolabeled fludeoxyglucose. Positron emission tomography (PET) can be used to measure

title: Chronic traumatic encephalopathy
text: normal blood-brain barrier, there is an extended period of time between the initial events (head hits) and the development of any signs or symptoms. Nevertheless, autoimmune changes in blood of players may consist the earliest measurable event predicting CTE. Robert A. Stern, one of the scientists at the Boston University CTE Center, said in 2015 that "he expected a test to be developed within a decade that will be able to diagnose C.T.E. in living people". Investigators have demonstrated that immobilizing the head during a blast exposure prevented the learning and memory deficits associated with CTE that occurred when the

title: Barry Festoff
text: pHLOGISTIX, a company that focuses on blood-based biomarkers as companion diagnostics for neurotrauma and neurodegenerative diseases such as chronic traumatic encephalopathy (CTE), Alzheimer’s disease (AD), frontotemporal dementia (FTD), Parkinson’s disease (PD) and amyotrophic lateral sclerosis (ALS) in order to harness neuroinflammation and improve functional outcomes following trauma to the central nervous system (CNS). The ultimate goal is to provide a validated panel of nucleic acid and protein biomarkers in a novel analytic approach to allow the identification of patients with CTE and AD before symptoms develop, i.e., preclinical, while still at the stage of mild cognitive impairment, especially after early

title: Concussions in American football
text: living players, are associated with Alzheimer's disease. Previously, this type of exam could only be performed with an autopsy. Scientists at UCLA created a chemical marker that binds to the abnormal proteins and they are able to view this with Positron Emission Tomography (PET) scan. Researcher at UCLA, Gary Small explains, "Providing a non-invasive method for early detection is a critical first step in developing interventions to prevent symptom onset and progression in CTE". Post-Concussive Symptoms (PCS) is an area of recovery that is often not discussed. New evidence suggest that new recovery protocols have been recommended and designed to

title: Florbetaben (18F)
text: in practice, many individuals are misdiagnosed or remain even undiagnosed. The deposition of β-amyloid is considered as one hallmark in the pathogenesis of AD, and most likely begins years before the onset of detectable cognitive symptoms. Clinical testing using neuropsychology or memory examinations is the standard tool to diagnose AD as clinically possible or probable. Confirmation of the clinical diagnosis requires the identification of β-amyloid plaques in the brain. Until recently, this was only possible after death, in postmortem histopathology. The need of diagnosis confirmation during life has led to the development and incorporation of biomarkers, such as cerebrospinal fluid

title: Renal angina
text: and prognosis of AKI. The most frequently studied new biomarkers include Cystatin C (CysC), neutrophil gelatinase associated lipocalin (NGAL), interleukin-18, liver-fatty acid binding protein (l-FABP), and kidney injury molecule-1 (KIM-1). Children following cardiopulmonary bypass are often used to derive biomarker performance and validate optimal cut-off values given a known timing and duration of insult, relative homogeneity, and freedom from co-morbidities. Unfortunately, when these and other biomarkers are applied to a more heterogeneous patient population (the general intensive care unit, non-critically ill patients, patients in the emergency department), they demonstrate less robust predictive performance. The inability to detect AKI in the

title: Chronic traumatic encephalopathy
text: to tau. It is being tested in several clinical trials. A putative biomarker for CTE is the presence in serum of autoantibodies against the brain. The autoantibodies were detected in football players who experienced a large number of head hits but no concussions, suggesting that even sub-concussive episodes may be damaging to the brain. The autoantibodies may enter the brain by means of a disrupted blood-brain barrier, and attack neuronal cells which are normally protected from an immune onslaught. Given the large numbers of neurons present in the brain (86 billion), and considering the poor penetration of antibodies across a

title: Chronic traumatic encephalopathy
text: prolonged post-concussion syndrome (PCS, where symptoms begin shortly after a concussion and last for weeks, months, and sometimes even years) and CTE symptoms can be difficult. Research studies are currently examining whether neuroimaging can detect subtle changes in axonal integrity and structural lesions that can occur in CTE. Recently, more progress in in-vivo diagnostic techniques for CTE has been made, using DTI, fMRI, MRI, and MRS imaging; however, more research needs to be done before any such techniques can be validated. PET tracers that bind specifically to tau protein are desired to aid diagnosis of CTE in living individuals. One

title: Lead time bias
text: prolong the life of someone but just determine the propensity of the person to a disease or medical condition such as by DNA testing. No additional life span has been gained and the patient may even be subject to added anxiety as the patient must live for longer with knowledge of the disease. For example, the genetic disorder Huntington's disease is diagnosed when symptoms appear at around 50, and the person dies at around 65. The typical patient, therefore, lives about 15 years after diagnosis. A genetic test at birth makes it possible to diagnose this disorder earlier. If this

title: Bennet Omalu
text: evidence of CTE in a 27-year-old Iraq War veteran who suffered from post-traumatic stress disorder (PTSD) and later committed suicide. Omalu's paper links PTSD to the CTE spectrum of diseases and calls for further study. Omalu is lead author in a study published in November 2017 that for the first time confirmed CTE in a living person. A chemical tracer, FDDNP, binds to tau proteins, detectable by positron emission tomography, and associated with the distinctive topographical distributions characteristic of CTE. Tested on at least a dozen former NFL players, it was confirmed postmortem in former linebacker Fred McNeill. In March

title: Alivecor
text: year. A study by the Cleveland Clinic showed the KardiaBand could distinguish between atrial fibrillation and a normal heart rhythm with 93 percent sensitivity and 94 percent specificity; sensitivity increased to 99 percent with physician review of the reading. The company is conducting research with Columbia University and the Mayo Clinic to determine if the KardiaBand can identify early warning signs of Long QT syndrome, a cause of sudden death, especially in young people. AliveCor presented research in March 2018 that it conducted with the Mayo Clinic showing that the KardiaBand can detect hyperkalemia, elevated levels of potassium in the

title: Predictive modelling
text: pneumonia. In 2018, Banerjee et. al. proposed a deep learning model - Probabilistic Prognostic Estimates of Survival in Metastatic Cancer Patients (PPES-Met) for estimating short-term life expectancy (>3 months) of the patients by analyzing free-text clinical notes in the electronic medical record, while maintaining the temporal visit sequence.The model was trained on a large dataset (10,293 patients) and validated on a separated dataset (1818 patients). It achieved an area under the ROC curve (AUC) of 0.89. To provide explain-ability, they developed an interactive graphical tool that may improve physician understanding of the basis for the model’s predictions. The high accuracy

title: Overdiagnosis
text: survival statistic. The figure below shows how overdiagnosis - the detection of pseudodisease - inflates the survival statistic even when the number of deaths is stable. Imagine that there is no pseudodisease detected in current practice and that among 1000 patients diagnosed, only 100 are alive 10 years later (i.e. the 10-year survival is 100 divided by 1000 or 10%). Now imagine that in addition to identifying these cancers, spiral CT scanning also identifies 4000 patients with pseudodisease - all of whom survive 10 years, since they have non-progressive cancer. The new 10-year survival will include these patients in both

title: Troponin
text: death. Both proteins are now widely used to diagnose acute myocardial infarction (AMI), unstable angina, post-surgery myocardium trauma and some other diseases related with cardiac muscle injury. Both markers can be detected in patient’s blood 3–6 hours after onset of the chest pain, reaching peak level within 16–30 hours. Elevated concentration of cTnI and cTnT in blood samples can be detected even 5–8 days after onset of the symptoms, making both proteins useful also for the late diagnosis of AMI. Cardiac troponin T and I are measured by immunoassay methods. Troponin elevation following cardiac cell necrosis starts within 2–3 hours,

title: Clinical endpoint
text: biochemical biomarkers. In clinical cancer research, common endpoints include discovery of local recurrence, discovery of regional metastasis, discovery of distant metastasis, onset of symptoms, hospitalization, increase or decrease in pain medication requirement, onset of toxicity, requirement of salvage chemotherapy, requirement of salvage surgery, requirement of salvage radiotherapy, death from any cause or death from disease. A cancer study may be powered for overall survival, usually indicating time until death from any cause, or disease specific survival, where the endpoint is death from disease or death from toxicity. These are expressed as a period of time (survival duration) e.g., in months.

title: Imaging biomarker
text: are also extremely expensive and time consuming. End-points, such as morbidity and mortality, are used as measures to compare groups within a clinical trial. The most basic endpoint used in clinical trials, mortality, requires years and sometimes decades of follow-up to sufficiently assess. Morbidity, although potentially faster to measure than mortality, can also be a very difficult endpoint to measure clinically, as it is often very subjective. These are some of the reasons why biomarkers have been increasingly used in clinical trials to detect subtle changes in physiology and pathology before they can are detected clinically. The biomarkers act as

title: CAPP-Seq
text: where ctDNA correctly determined the outcome of a patient when medical imaging was wrong. In one cause, the imaging predicted relapse based on a suspected residual tumor which turned out to only be radiation induced inflammation, but ctDNA was not detected and the patient did not relapse. In another case, the imaging showed no tumor but ctDNA was detected and the patient relapsed shortly afterwards. In another study on DLBCL (diffuse large B cell lymphoma), ctDNA was also found to be predictive of relapse. Biopsies are invasive and associated with risks to the patient. Therefore, multiple biopsies to monitor disease

title: ST2 cardiac biomarker
text: there is no level that perfectly separates patients with and without heart failure for disease diagnosis. However, as a prognostic marker it has been clearly shown that patients are at a higher risk of adverse outcomes when ST2 levels are above a cutoff value of 35 ng/mL. ST2 is a strong predictor of cardiovascular death and risk of developing new heart failure in ST Elevation Myocardial Infarction (STEMI) & NSTE-ACS patients. In patients presenting with Acute Coronary Syndrome (ACS), those in the highest quartile (above 35 ng/ml) have more than 3 times higher risk of cardiovascular death and new heart

title: Biomarker (medicine)
text: difficult diagnosis or even make it possible in the first place. A number of diseases, such as Alzheimer's disease or rheumatoid arthritis, often begin with an early, symptom-free phase. In such symptom-free patients there may be more or less probability of actually developing symptoms. In these cases, biomarkers help to identify high-risk individuals reliably and in a timely manner so that they can either be treated before onset of the disease or as soon as possible thereafter. In order to use a biomarker for diagnostics, the sample material must be as easy to obtain as possible. This may be a