Researchers develop ‘game-changing’ blood test to identify concussions

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Researchers at the University of Queensland are trying to develop a new blood test that has global implications for identifying and diagnosing concussion.

The research project is a partnership between the University of Queensland, World Rugby, Rugby Australia, Qscan, Trajan and Sonic Health.

To identify biomarkers in the blood that indicate a concussion, the project will use advanced brain imaging, cognitive testing and blood analysis and will involve testing volunteers involved in high school rugby and basketball.

Project Principal Investigator, Assoc. Professor Fatima Nasrallah of the University of Queensland said in a press release that a blood test, which can identify a concussion, would have global implications for the field of sport.

“If we can find a biomarker that accurately reflects how the brain responds to and recovers from a concussion, that will be a game-changer for sports,” Nasrallah said.

“We could then develop a tool on the pitch to inform diagnosis and action needed in real time, such as removing players from the pitch or only returning when it is safe to do so.

“Ultimately, if we identify a biomarker and develop a simple point-of-care tool that can accurately diagnose concussions on the sideline or in the clinic, we will help improve the safety of school, community and professional sports. »

Sidney Crosby of the Pittsburgh Penguins takes a shot from Ian Cole of the St Louis Blues. Crosby is out for the second time this season with concussion symptoms. (Jamie Sabau/Getty Images)

Blood tests would facilitate concussion tests

Associate Professor Eva Valera, of Harvard Medical School, wrote in a Harvard Health Blog that concussion blood tests would seek to measure substances, such as proteins and enzymes, that are released into the blood when the brain suffers an injury.

Valera said concussion blood tests could be used to avoid unnecessary imaging scans, which are expensive and expose the body to radiation, without missing a serious brain injury. They also believe that such blood tests could grow to be more sensitive to finding intracranial lesions than imaging scans.

Currently in elite sports concussions are diagnosed using the SCAT5 test or Rugby Australia’s Head Injury Assessment (HIA) protocol, both of which identify concussion based on subjective behavioral symptoms. According to the Centers for Disease Control and Prevention, symptoms of a concussion include confusion, agitation, vomiting, pain or pressure in the head, blurred vision, and a change in mood, personality, or behaviour.

The British Journal of Sports Medicine’s SCAT5 test can be properly administered by a licensed healthcare professional in 10 minutes with a time-measuring device; the test includes cognitive, neurological and physical screening. The SCAT5 includes questions on numeracy, memory recall, reading, history of head trauma, and assessment of physical symptoms such as ocular response and neck or head pain.

The HIA protocol consists of three steps, the first of which is for a team or game doctor to identify a player’s concussion potential through direct observation or video examination. If the player shows obvious signs of concussion, he is immediately and permanently removed from the game; if they only have the potential, the player is taken offsite and given a reformatted SCAT5 test. Players with a potential concussion are not permitted to return to play during a 12 minute period during which the SCAT5 test is performed.

Steps two and three of the protocol are follow-ups performed three hours and two nights off after the end of the game. The second step is in place to identify an early concussion and consists of re-administering the SCAT5 test. The third step is established to identify a late concussion and involves a clinical assessment supported by the SCAT5 test and a computational neuro-cognitive tool, which is chosen by the team.

This means that many Australian sports bodies are taking a ‘when in doubt, avoid them’ approach to possible concussions, in line with Sport Australia guidelines. But, elite and community games lack a uniform review process for players after they suffer a possible concussion, and a tool that provides objective, evidence-based concussion diagnoses would address this. this need.

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SYDNEY, AUSTRALIA – AUGUST 16: Israel Folau of the Wallabies heads the ball during the Rugby League match between the Australian Wallabies and New Zealand All Blacks at ANZ Stadium on August 16, 2014 in Sydney, Australia. (Photo by Mark Kolbe/Getty Images)

What the tests would mean for rugby

Welcoming the new research project, World Rugby Chief Medical Officer Dr Éanna Falvey said the potential for the study is huge.

“If cutting-edge research from the University of Queensland could uncover a blood test that identified concussion in community play, it would bring huge benefits not just to rugby but to the sport of the world as a whole.”

“World Rugby is committed to never standing still on player welfare,” Falvey said.

“Our six-point plan to become the most progressive sport in the world in this area includes a commitment to invest in science and research, and this study is just one example of the implementation of our plan.”

In 2021, World Rugby announced a six-point plan to advance the sport’s focus on player wellbeing, with the wellbeing of former players, women and community play at the centre. initiative.

The plan includes support for former players, prevention of head injuries through research and technological innovation, a review of the law focusing on well-being, special attention to female players, investment in programs concussion education and appropriate play; and continued engagement and collaboration with the rugby community.

“Our mission is to be the most progressive, open and collaborative sport when it comes to the welfare of our players at all levels,” World Rugby chief executive Alan Gilpin said in a press release. .

“Rugby is a sport that offers tremendous positive health and well-being benefits to those who play it, and we want many more people to experience it.”

Falvey said that while the risks associated with youth and community play are not comparable to elite play, this research illustrates rugby’s continued focus on achieving objective tests to identify and manage brain damage. She said rugby is addressing this concern while changing laws, tackling techniques and education to advance injury prevention strategies for youth rugby.

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