Editors' ChoiceHEAD INJURY

A Marker for Concussion?

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Science Translational Medicine  09 Apr 2014:
Vol. 6, Issue 231, pp. 231ec64
DOI: 10.1126/scitranslmed.3009045

Repeated concussions that allow the brain little time for recovery are a known risk factor for long-term neurological complications. Detection and monitoring of concussions based on clinical evaluation and self-reporting is subjective and can be inaccurate. Unfortunately, there is no current test for concussion that is objective, reliable, and easy to administer.

In a new study, researchers measured three proteins in blood—total tau (an indicator of axonal injury), S-100 calcium binding protein B (an indicator of astroglial activation), and neuron-specific enolase (an indicator of neuronal injury)—in professional ice hockey players in Sweden during the 2012–2013 season. In players who sustained a concussion, blood samples were collected at 1, 12, 36, 48, and 144 hours after the head injury. The investigators then correlated these protein concentrations with clinical concussion and recovery. Twenty-eight players had repeated blood samples taken after sustaining a concussion. Total tau was the most reliable marker, with an increase in tau concentrations in all post-concussion blood samples as compared with preseason levels. The highest tau concentrations occurred immediately after concussion and then decreased during rehabilitation. 

Although there is much more work to do before total tau could be considered an accurate marker of concussion, the correlation of total tau with clinical symptoms in this small study of ice hockey players is a promising first step on the road to finding an accurate biomarker of concussion.

P. Shahim et al., Blood biomarkers for brain injury in concussed professional ice hockey players. JAMA Neurol. 10.1001/jamaneurol.2014.367 (2014). [Full Text]

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