NYC Gazette

Researchers at the Hospital for Special Surgery (HSS) have presented two studies that could influence the treatment of mild traumatic brain injury (mTBI). The studies offer insights into using a potential blood biomarker for assessing injuries and suggest that the drug amitriptyline may help speed recovery. These findings were unveiled at the American Academy of Neurology 2025 annual meeting.

Currently, diagnosing concussions, a form of mTBI, remains a challenge due to the lack of objective biomarkers. Ayse Erdemir, the clinical research coordinator at HSS and first author of both studies, noted that despite consensus guidelines, individual treatment is often determined by physicians. Previous research has indicated a possible association between C-reactive protein (CRP), an inflammatory marker, and traumatic brain injury (TBI), but this relationship needs further exploration.

Erdemir explained that no established pharmacological treatments are available for mTBI at present, and treatment typically involves physical therapy and lifestyle adjustments. While past studies on using amitriptyline for mTBI have been inconclusive, the new research supports its use under certain conditions.

The first study analyzed data from 383 concussion patients and focused on high-sensitivity CRP (hsCRP) levels. "We found that higher levels of hsCRP were associated with more frequent reporting of symptoms like sadness and trouble falling asleep," Erdemir stated, noting that recovery time was longer for patients with abnormal hsCRP levels. She mentioned that the findings suggest hsCRP could be part of a biomarker panel for assessing acute mTBI.

In the second study, researchers focused on the use of amitriptyline, a drug traditionally used as an anti-depressant, in the same patient group. Patients prescribed amitriptyline were often those with histories of depression, anxiety, and migraines and suffered from more severe concussion symptoms. Despite this, their recovery rate equaled that of patients with less severe cases. "Amitriptyline seems to play a supportive role in helping patients with more frequent and severe baseline symptoms to recover," said Erdemir.

The research team intends to do more studies to explore the clinical applications, including a randomized controlled trial comparing amitriptyline to a placebo and other medications used for treating headaches.