Do we have a blood test for detecting concussion severity?

Blind side hit and now I feel as though I am wading through a thick fog. I can’t concentrate and even the sound of my breathing hurts my head. Concussions are a rapidly growing problem in both professional athletes and young people with the number of sports related concussions in the past decade increasing by 60%. Frighteningly, 20% of all sports related injuries (including concussions) occurred in school facilities and 70% of all emergency room concussion visits are for people between the ages of 10-19. For male children, football and cycling are the cause of the majority of concussions while for female children it is soccer or basketball. Concussions can cause short or long term problems with learning, thinking and language and may lead to increased risks for epilepsy, Alzheimer’s disease, and Parkinson’s disease. Longer-term problems associated with concussions, usually called post concussion syndrome, can include dizziness, headaches, sensitivity to light or noise, irritability, depression, anxiety, and cognitive impairments. Long gone are the days where a concussion was considered nothing more than a bruise on the brain; we now know that there can be profound damage to the brain. Typically, patients are told to rest, avoid electronics, take a break from school or work and when your symptoms subside you can resume your daily routine. The problem with treating concussions is that there is no clear point in time where someone can say they are properly healed from their concussion. What is really needed is some sort of test that is easy to administer and can tell us not only when a concussion has been successfully treated, but also the severity of the concussion or likelihood that someone will suffer from post concussion syndrome. That is where work by researchers from Philadelphia and Sweden shows promise.

The work looked at professional hockey players in the Swedish hockey league who had suffered a concussion at some point during the season and identified levels of a protein fragment in their blood called SNTF (or calpain-derived alpha-spectrin N-terminal fragment if you wanted to know). SNTF has been shown in the past to be released when neurons in the brain are damaged and so there is plausibility to why it would be present in concussions. When the researchers compared the levels of SNTF after the concussion to before the players had the concussion they saw the levels of it increased in the blood as soon as 1 hour after the concussion and the levels returned to normal when the symptoms of the concussion disappeared. The most interesting thing though was that the players who had to stay out for longer periods of time because of post concussion syndrome had elevated levels of SNTF for over 6 days and their levels were higher after 36 hours than those who recovered quickly meaning that researchers could distinguish those skaters who would have worse symptoms and take longer to heal.

This is huge, and if the results can be repeated in more people then we may have a diagnostic test that can help determine if someone has a concussion and how serious it is. The NHL and NFL may benefit from this sort of research to increase player safety and as such hopefully they can find someway to participate in future studies. The capability to measure the progression of a concussion in the blood would allow us to ensure that people don’t rush back too soon and make sure that kids who get a concussion are adequately taken care of to ensure they don’t suffer future cognitive problems. It may also help prevent repeated concussions that many athletes suffer from. In the future, we can envision a scenario where people suspected of suffering a concussion are given a blood test for SNTF and monitored for their recovery. This would allow us to make informed recommendations on when to return to activities. This video has good information on concussions, symptoms and resources for those who are interested.

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