Could it possibly be that simple? A blood test that would diagnose and confirm the presence of a concussion and determine when the neural sequellae of the concussion had resolved? It appears that such a test may indeed be on our horizon.
In June of 2014, a study was published in JAMA-Neurology by a group of researchers in Sweden that summarized their initial attempts to identify a blood serum marker that would correspond to elevated protein levels in athletes who had sustained a concussion. Total tau (T-tau) protein, S-100 calcium-binding protein B, and neuron-specific enolase concentrations in plasma and serum were measured.
Participants in the study were professional athletes in the Swedish Hockey League. 288 players consented to participate in the study. 47 players underwent blood sampling prior to the start of the season. 35 players had a concussion during the season; 28 of which underwent repeated blood sampling up until their return to play.
Although the participant sample was small by research standards, the results of this preliminary study were compelling. Concussed players had increased levels of the Total-tau protein compared with pre-season values. The levels of the S-100 calcium-binding protein B were also elevated relative to pre-season values. The highest biomarker concentrations of the 2 proteins were seen immediately after a concussion, and they decreased during rehabilitation. The eventual goal of the researchers is develop a protocol whereby these blood based biomarkers can be developed into a clinical tool that will guide physicians in their quest to promote a safe return to physical activity. These implications also have bearing with the decisions employed in returning an individual to the school and work environments as well. For additional details about this study, please refer to:
Pashtun, Shahim, MD et al. “Blood Biomarkers for Brain Injury in Concussed Professional Hockey Players”. JAMA-Neurology. June 2014; Vol. 71: No. 6, pp. 684-692.
Of further interest…….Together with collaborating scientists across multiple institutions around North America and Europe, The Mayo Clinic is actively engaged in the development of clinical biomarkers for the diagnosis of, and recovery monitoring from concussion. Clinical researchers in Arizona and Minnesota have launched a prospective study in Junior A League hockey players to evaluate the correlation among clinical, imaging and serum biomarkers following concussion.
The significance of these early efforts is substantial. ED/ER physicians are increasingly wary about ordering CT Scans for individuals with suspected concussion as these neural images are almost always “clean” and devoid of visual “damage” to the brain. This is especially relevant in the case of exposing young children to unwarranted radiation. A blood serum test would allow for the diagnosis and monitoring of concussion in a more cost effective and less invasive manner. These research efforts could be the ultimate “game changer” for concussion management world wide.
For readers already familiar with my monthly blog, I will be posting an additional blog this month with free, public domain resources on Assistive Technology for Cognitive Retraining, so stay tuned.
As always, thanks for reading, Gina