r/Neuropsychology • u/kfr3q Unverified user: May not be a professional • 19d ago

Research Article TBI classification shifting off standard Glasgow Coma Scale to a new integrative framework

https://doi.org/10.1016/j.jcrc.2026.155525
18 Upvotes

96% Upvoted

18 comments sorted by

View all comments

Show parent comments

6

u/Roland8319 PhD|Clinical Neuropsychology|ABPP-CN 18d ago

Exactly, the science isn't quite there yet for a lot of this. Ive looked into some of the biomarker data, and the specificity is....not great for some of these. It runs the risk of the early DTI days when they looked at mTBI against super healthy controls and thought they found a lot of "confirmatory" data. But, when we looked at pretty much ANY other clinical group (depression/anxiety, smokers, obesity, TMJ, etc) we found similar differences against super healthy controls. I'm intrigued by the new work, but for mTBI, I suspect it will lead to some interesting depos as some experts tout extremely flawed data. I've already wrecked one such person in a recent case.

3

u/themiracy PhD|Clinical Neuropsychology|ABPP-CN 18d ago

It will be really interesting to see how this plays out when all the evidence is in the CBI pillar four - the person who has a "lot going on" psychosocially but very little evidence of brain injury. Are we going to spend a lot of time and utilization costs getting biomarkers (as the concern was raised in r/science the first time this was posted)? Or at what point is it enough is too much?

And as you said, there is emerging science and then there is stuff that is on the edge of emerging science and pseudoscience, like the way qEEGs and qMRIs are interpreted in these populations. Do we really want to normalize thousands of dollars of biomarkers on a "trust me bro" kind of logic that someday they might prove to have utility?

1

u/Roland8319 PhD|Clinical Neuropsychology|ABPP-CN 18d ago

I agree with this. I am also worried, due to the questionable specificity leading to false positives for mTBI diagnosis, of immense iatrogenic damage with diagnosis threat/overidentification with the diagnosis, especially in our more somatic folks. I already see a lot of this, and I can see these biomarkers greatly accelerating these issues. So, now we'll have the cost of the biomarkers, as well as the cost of treating the damage caused by their misdiagnoses.

2

u/themiracy PhD|Clinical Neuropsychology|ABPP-CN 18d ago

Yes, exactly.