Saliva Test: Catching Concussions at The Game


CHICAGO, Ill. (Ivanhoe Newswire)— Super Bowl Sunday is February seventh—despite an increase in concussion awareness and response, there were 224 reported concussions in the NFL during the 2019 season. Now, scientists at Penn State College of Medicine and several other universities are developing a saliva test that could mean an almost instant diagnosis for athletes at all levels.

Helmet to helmet, or helmet to gear, or ground. A crunching sound that signals serious impact, but unlike other sports injuries, a concussion is difficult to diagnose quickly.

Lewis Simon, who suffered a concussion playing sports shared with Ivanhoe, “You can see an arm that’s broken through an x-ray, but if you get hit and you look a little wheezy but tell your coach you’re fine, guess what? You’re going out the next play.”

Most schools and sports teams now follow a specialized set of steps to diagnose and care for an athlete who suffers a blow to the head—it’s known as a concussion protocol. But the diagnosis can take time. Now, researchers are developing a new saliva test to diagnose concussion by identifying a microRNA biomarker secreted by cerebral nerves that can be picked up in a patients’ spit. It’s a test that can be done as soon as an injured patient comes off the field and is non-invasive.

Elizabeth Pieroth, PsyD, ABPP, MPH, director of the concussion program at Midwest Orthopaedics at Rush explained, “In the past, other work has looked at things like cerebral spinal fluid, which means a lumbar puncture, which you’re not doing on the side of a soccer game!”

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Studies show this biomarker is critical as it’s exclusive to only concussions. Researchers in the Penn State study found that the test is over 92 percent accurate.

“So, if we have something that says, ‘yes, in fact, you have a concussion’, and we can remove them from play is a game changer, it’s the Holy Grail of concussion work!” Pieroth shared.

The study’s authors at Penn State have now teamed up with Quadrant Biosciences and have received a grant to produce the technology. Doctors say this test will be game changing not only for trainers to use field-side in sports, but also by emergency responders at the scene of an accident, or even by army medics on a battlefield.

Contributors to this news report include: Cyndy McGrath, Executive Producer & Field Producer; Sabrina Broadbent, Field Producer; Roque Correa, Editor.

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REPORT:       MB #4862

BACKGROUND: Concussions occur as the result of an impact or physical injury to the head. Concussions are classified as a traumatic brain injury that affects brain function and can temporarily affect balance, memory and coordination. Some concussions can result in loss of consciousness; however, most do not. Signs and symptoms of concussions can be subtle, may not show up immediately, and can last for days, weeks or even longer. The most common physical symptoms of a concussion are headache, ringing in the ears, nausea, vomiting, fatigue or drowsiness, and blurred vision. Cognitive symptoms may include confusion or feelings of brain fog, amnesia surrounding the traumatic event that caused the concussion, and dizziness or ‘seeing stars’. In rare cases, a hematoma, or dangerous collection of blood, may form on the brain and squeeze the brain against the skull. Signs and symptoms of this more dangerous complication are one pupil being larger than the other, drowsiness or loss of consciousness, persistent and worsening headache, slurred speech, weakness, or numbness, unusual behavior, increasing confusion, or agitation. If any of these signs are noticed patients should be taken to an emergency department immediately.


DIAGNOSING: Concussions may include short-term symptoms such as headaches, dizziness, and confusion. In order to diagnose a concussion, physicians currently use symptom scales and neurocognitive tests to assess the patient. Testing may also be repeated and compared to previous tests to detect changes. The diagnostics can include clinical reaction time assessments to test for an extremely common cognitive sequalae of concussion—impaired reaction time. However, researchers are concerned about the reliability of these methods as they are subject to both patient and physician bias such as underreporting symptoms to keep an athlete in play. Symptoms may also be subtle or have delayed onset which can lead to further complications with immediate diagnosis.


NEW TECHNOLOGY: Now, a new method of diagnosing concussions is being developed in the form of a saliva test by analyzing microRNA profiles found in a patient’s spit following a head trauma. Assessing the microRNA in the saliva is a non-invasive way to test for concussion without the bias and influence of a patient’s feelings or motives. In a clinical study conducted by Penn State, researchers studied 538 participants across 11 clinical sites. Half of participants had a reported concussion within two weeks of the start of the trial, the other half did not, but had conditions that mimic concussion symptoms like anxiety, depression, ADHD, or chronic headaches. Using RNA sequencing to evaluate participants’ samples, researchers found that the combination of saliva biomarkers and patient-reported symptoms proved to be 92.5 percent accurate in differentiating patients with and without a concussion





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Doctor Q and A

Read the entire Doctor Q&A for Elizabeth Pieroth, PsyD, ABPP, MPH, director of the concussion program

Read the entire Q&A