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Simple test for sport-related concussion

Wednesday March 24th 2021

Researchers have developed a non-invasive test which accurately diagnoses concussion after brain injury from sport.

Dr Valentina Di Pietro of the University of Birmingham, UK, and colleagues explain that concussion is "induced by biomechanical forces that typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously".

They searched for a new diagnostic test because many cases are misdiagnosed or unidentified, risking athletes' long-term brain health.

They looked at the diagnostic potential of salivary small noncoding RNAs by testing saliva from male elite rugby players across the 2017 to 2019 seasons.

In total, 1,028 men provided samples, with 156 also giving samples alongside standardised head injury assessments during, immediately after, and 3-4 days after a game.

The samples were compared with those from 102 uninjured players and 66 players with musculoskeletal injuries.

Analysis showed differences in 32 salivary small noncoding RNAs between those with and without concussion, when tested immediately after the game and 3-4 days later.

Accuracy was comparable to the level of assessment available in a professional sport setting.

This study of non-invasive concussion biomarkers "has identified unique signatures of concussion in saliva of male athletes diagnosed with concussion", they report today (24 March) in the British Journal of Sports Medicine.

“Small non-coding RNAs can provide a diagnostic tool that might reduce the risk of missing this type of injury at all levels of participation,” they add.

The researchers also point out that these biomarkers also present an opportunity to develop a new diagnostic tool in primary care and emergency medicine departments.

Dr Di Pietro said: "A non-invasive and accurate diagnostic test using saliva is a real game changer and may provide an invaluable tool to help clinicians diagnose concussions more consistently and accurately.

"In professional sports, this diagnostic tool may be used in addition to current head injury assessment protocols and return to play evaluation to ensure the safety of individuals."

Dr Simon Kemp, medical services director of the Rugby Football Union, said: "While still a way from having something that can be used in community rugby, it is extremely encouraging to now be able to start to develop a rapid and non-invasive test which could add real value particularly at a grassroots level of the game.”

Di Pietro, V. et al. Unique diagnostic signatures of concussion in the saliva of male athletes: the Study of Concussion in Rugby Union through MicroRNAs (SCRUM). British Journal of Sports Medicine 24 March 2021; doi: 10.1136/ bjsports-2020-103274

[abstract]

Tags: A&E | Brain & Neurology | Fitness | Pharmaceuticals | UK News

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