Patient Frequently Asked Questions
Neural-Injury Assessment Test™ Complete Panel and Neural-Injury Assessment Test™ Biomarker Panel
Understanding the Test
What is the Neural-Injury Assessment Test™ Complete Panel?
The Neural-Injury Assessment Test™ Complete Panel combines protein biomarker analysis and genetic testing to provide objective biological data related to brain injury, neurological function, cellular repair processes, and certain neurological risk factors.
What does the Neural-Injury Assessment Test™ Complete Panel measure?
The Complete Panel measures:
Four Protein Biomarkers:
GFAP (Glial Fibrillary Acidic Protein)
UCH-L1 (Ubiquitin Carboxyl-Terminal Hydrolase L1)
S100B (S100 Calcium-Binding Protein B)
NF-H (Neurofilament Heavy Chain)
Two Genetic Markers:
APOE (Apolipoprotein E)
MTHFR (Methylenetetrahydrofolate Reductase)
These biomarkers and genetic markers provide information related to neuronal injury, glial injury, astrocyte injury, blood-brain barrier disruption, cellular response and recovery processes, and certain neurological risk factors.
What is the Neural-Injury Assessment Test™ Biomarker Panel?
The Neural-Injury Assessment Test™ Complete Panel combines a four-protein biomarker analysis to provide objective biological data related to brain injury, neurological function, cellular repair processes, and longitudinal monitoring.
What does the Neural-Injury Assessment Test™ Biomarker Panel measure?
The Neural-Injury Assessment Test™ measures four protein biomarkers:
GFAP (Glial Fibrillary Acidic Protein)
UCH-L1 (Ubiquitin Carboxyl-Terminal Hydrolase L1)
S100B (S100 Calcium-Binding Protein B)
NF-H (Neurofilament Heavy Chain)
Together, these protein biomarkers provide objective biological data related to neuronal injury, glial injury, astrocyte injury, cellular response and repair processes, neuroaxonal injury, and the longitudinal monitoring of brain injury.
What brain injuries can these tests provide insights into?
The Neural-Injury Assessment Test™ is a frontline test that can be used when evaluating patients with:
• Concussions and traumatic brain injuries
• Motor vehicle accidents
• Falls
• Sports-related injuries
• Military blast exposures
• Occupational injuries
• Repetitive head impacts
• Heavy metal exposures
• Carbon monoxide exposure
• Conditions associated with inflammation affecting the brain and nervous system
• Neuroimmune activation
• Environmental neurotoxic exposures
Results should always be interpreted in conjunction with your medical history, symptoms, and other clinical findings.
Blood Collection Process
How is the test performed?
The test is performed through a simple blood draw conducted by a trained phlebotomist, and typically takes only a few minutes to complete.
How will my blood sample be collected?
Your blood sample may be collected through one of the following options:
• In-office collection at your provider's clinic
• Mobile phlebotomy, where a trained professional comes to you
• An outpatient collection center
Available collection options may vary based on your provider and location.
How much blood is collected?
Only two small tubes of blood are required. The blood draw is similar to many routine laboratory tests.
Do I need to complete paperwork before my blood collection appointment?
Yes. Required paperwork must be completed before blood collection can be scheduled. This process may be immediate or may take up to 72 business hours.
Will someone contact me to schedule my blood draw?
Yes. If mobile or outpatient collection is needed, a Brazos Patient Scheduling Coordinator will contact you within 24 business hours after your provider orders your test.
What if my provider collects my blood in their office?
If your provider offers in-office blood collection, no scheduling from Brazos Neuroscience is necessary. Your provider will schedule your blood draw.
Shipping & Test Kits
When will my test kit arrive?
Once your blood collection appointment has been scheduled, your test kit will be shipped overnight. Test kits are typically shipped Monday through Friday.
What should I do when my test kit arrives?
When your test kit arrives:
• Open the shipping package and remove the test kit.
• Place the cold pack in your freezer for at least 2–4 hours before your scheduled blood draw.
• Keep the patient card inside the test kit.
• Do not open any collection supplies, tubes, or packaging inside the kit. Keep all contents sealed to help maintain sterility and ensure proper specimen collection.
Your collection phlebotomist will use the materials in the kit during your blood draw appointment.
Will I receive a test kit if my blood is collected in my provider's office?
No. The test kit will be shipped directly to your provider's office and will be available at the time of your blood draw.
What should I have during my blood collection appointment?
Please have the following available at your appointment:
• Your test kit
• Any paperwork requested by your provider or Brazos Neuroscience
• The cold pack. Make sure it has been frozen for at least 2–4 hours prior to your appointment.
What happens if my sample needs to be recollected?
Occasionally, a blood sample may not meet laboratory requirements for testing.
If a recollection is needed:
• Brazos Neuroscience will contact you directly.
• A Patient Scheduling Coordinator will assist with rescheduling your blood draw.
• A replacement test kit will be shipped to you.
Test Results
How long does it take to receive my test results?
Results are typically available within 7–10 business days after the laboratory receives your sample.
How will I receive my test results?
Your results will be securely delivered to both you and your healthcare provider. Your healthcare provider will review the findings with you and discuss how they may fit into your overall clinical evaluation and care plan.
Scientific & Clinical Information
How accurate is the test?
The Neural-Injury Assessment Test™ demonstrates:
99% sensitivity
93% specificity
How long after a brain injury can the Neural-Injury Assessment Test™ be performed?
The Neural-Injury Assessment Test™ may provide clinically relevant information following both recent and past injuries. Some patients are tested shortly after an event, while others may be evaluated months or years later.
Because every individual and every injury is different, there is no single timeframe that applies to all patients.
Your provider ordered this test because they believe it will help provide valuable insights when considered alongside your clinical history, symptoms, and other diagnostic findings.
What quality standards does Brazos Neuroscience’s laboratory follow?
The Neural-Injury Assessment Test™ is performed in a Clinical Laboratory Improvement Amendments (CLIA)-certified and College of American Pathologists (CAP)-accredited laboratory, reflecting compliance with rigorous federal and industry standards for laboratory quality, analytical performance, and ongoing quality assurance. The biomarkers included in the test are supported by a growing body of scientific literature and research related to traumatic brain injury, neurotoxicity, neuroinflammation, and neurological health.
Protein Biomarkers (GFAP, UCH-L1, NF-H, S100B)
Are the blood-protein biomarkers analyzed in this test qualitative or quantitative?
Brazos Neuroscience's protein biomarker analysis is designed to provide quantitative measurements of specific proteins in the blood associated with neurological-related injuries or neurological conditions. These quantitative measurements can assist healthcare providers in evaluating neural injuries, monitoring changes over time, and correlating findings within a comprehensive clinical assessment framework.
What do blood-protein biomarkers measure?
Protein biomarkers measure the presence of specific proteins linked to the structural and cell maintenance components of brain cells that are released into the bloodstream following various stressors and injuries (e.g., neuroinjury, neuroinflammation, neurotoxicity, neurodegeneration, and neurotrauma).
Elevated levels of these proteins may suggest brain cell changes, cellular damage, or inflammatory responses. By analyzing protein biomarkers associated with brain injury, healthcare providers use these results of this test in conjunction with clinical evaluations to inform overall assessments of brain function, monitor biomarkers over time, and support personalized recovery strategies.
How long could blood-protein biomarker levels be elevated after a brain injury?
Biomarkers associated with brain injuries may change over time. Published studies have reported biomarker elevations persisting for varying lengths of time; however, no definitive timeline has been established across all biomarkers, patient populations, and testing platforms.
Healthcare providers should consider the timing of biomarker levels and trends over time when interpreting results within the appropriate clinical context. Additionally, this test does not establish injury severity or timing of a brain injury event.
Do elevated blood-protein levels suggest further evaluation?
While this test does not independently recommend or rule out additional assessments, healthcare providers may consider further evaluation if symptoms persist, worsen, or do not align with expected clinical progress, as determined within a clinical framework.
Additional assessments may include:
• Comprehensive Neurological Examination
• Vestibular/Oculomotor Testing
• CT or MRI Scans, including Diffusion Tensor Imaging (DTI)
• Assessments for Exercise Intolerance (Autonomic Dysfunction)
• Neuropsychological Assessment
• EEG/qEEG Scans
Can the protein biomarkers be monitored over time?
Yes. Protein biomarkers can be measured periodically to help providers evaluate biological changes over time and monitor recovery or progression. Many providers choose to repeat testing every 3 months to monitor changes over time.
Genetic Markers (APOE, MTHFR)
What are genetic variants and how do they play a role in the brain and nervous system?
Genetic variants are common alterations in the DNA sequence that may influence individual traits and health.
APOE and MTHFR genetic variants provide information about inherited factors that may influence cognitive function, neurological conditions, and individual responses to injury or disease.
Having a genetic variant alone does not mean an individual will develop or experience symptoms related to a specific condition. Genetic variants should never be assessed in isolation from other contributing factors, such as nutrition, environment, and overall health.
Healthcare providers may use genetic variant findings to better understand gene-environment interactions, assess potential risks, and identify lifestyle modifications to support patient care.
What is the APOE gene and how common is it to have an APOE ε4 allele?
The APOE gene encodes apolipoprotein E, a protein involved in lipid metabolism and the transport of cholesterol and other fats in the bloodstream.
APOE plays an important role in facilitating the repair and maintenance of neuronal membranes, promoting synaptic function, and supporting the overall health of brain cells.
Normal APOE function is important for communication between brain cells and may influence cognitive ability and memory.
The ε4 allele may be associated with impaired synaptic function and neuroinflammation, potentially contributing to cognitive changes over time.
The APOE ε4 allele is found in approximately 15–30% of people worldwide, depending on ethnicity and geographic region.
What health conditions are associated with the APOE ε4 allele?
Emerging scientific research indicates an association between the APOE ε4 allele and an increased risk of developing various mental health and neurological conditions, including but not limited to:
• Alzheimer's disease
• Lewy body dementia
• Cognitive impairment
• Increased neuroinflammation
• Anxiety
• Depression
What is the MTHFR gene and how common is it to have an MTHFR genetic variant?
The MTHFR gene encodes methylenetetrahydrofolate reductase, an enzyme that converts dietary folate (vitamin B9) into an active form called methylfolate.
The brain uses methylfolate for:
• DNA synthesis and repair
• Neurotransmitter production (e.g., serotonin, dopamine, norepinephrine)
• Methylation, a process that helps regulate genes and chromosomal structure
• Supporting myelin integrity to insulate nerve fibers
All of these functions are vital for optimal cognitive function.
Certain genetic variants of the MTHFR gene may reduce enzyme activity and impair folate metabolism. This may be associated with elevated homocysteine levels and reduced availability of methylfolate, potentially influencing cognition and mood.
MTHFR genetic variants are very common, with at least one copy of either the rs1801133 or rs1801131 variant found in approximately 60–70% of people worldwide, depending on ethnicity and geographic region.
What health conditions are associated with MTHFR genetic variants?
Emerging scientific research indicates an association between MTHFR genetic variants and an increased risk of developing various mental health and neurological conditions, including but not limited to:
• Alzheimer's disease
• Cognitive impairment
• Depression
Do the genetic markers need to be tested more than once?
No. Genetic markers only need to be tested once because your DNA does not change over time.
Neuroendocrine Assessment Test (Coming Soon)
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