Molecules in spit may be able to diagnose and predict length of concussions

November 20, 2017, Pennsylvania State University
Credit: CC0 Public Domain

Diagnosing a concussion can sometimes be a guessing game, but clues taken from small molecules in saliva may be able to help diagnose and predict the duration of concussions in children, according to Penn State College of Medicine researchers.

Researchers measured the levels of microRNAs—tiny snippets of noncoding RNA—in the of concussion . They found that the presence of certain microRNAs in saliva was able to better identify concussions and more accurately predict the length of than relying solely on patient surveys.

Steven Hicks, an assistant professor of pediatrics, said the findings—published today in JAMA Pediatrics—could result in a more fact-based way to diagnose and treat concussion patients.

"There's been a big push recently to find more objective markers that a concussion has occurred, instead of relying simply on patient surveys," Hicks said. "Previous research has focused on proteins, but this approach is limited because proteins have a hard time crossing the blood-brain barrier. What's novel about this study is we looked at microRNAs instead of proteins, and we decided to look in saliva rather than blood."

Concussions usually occur after a blow to the head—for example, during sports or a car accident. They can result in such symptoms as headache, nausea, confusion, amnesia or lack of consciousness. While most concussions clear up within two weeks, about one-third of patients will experience symptoms longer.

Patients are usually advised to rest and stay away from such physical activity as sports or gym class until their symptoms subside. Hicks said that while it is important to give the brain enough time to heal, it is difficult to accurately predict how long patients should rest.

"As a general pediatrician, I often see children with concussions," Hicks said. "The tools we use to diagnose and manage concussions are subjective—we do a physical exam and then have them answer a survey about their symptoms. Then, we make an educated guess about how long that child might continue to have a headache or feel nauseous. But those guesses aren't evidence-based and aren't always accurate."

MicroRNAs are found throughout the body and affect how genes are expressed depending on different conditions, like disease or injury. The researchers suspected these biomarkers might be able to predict the presence and length of concussions.

The researchers recruited 52 concussion patients between the ages of 7 and 21 for the study. Each participant was evaluated using the Sport Concussion Assessment Tool (SCAT-3)—a common tool that doctors use to inventory concussion symptoms and severity—within two weeks of their injury. The researchers also asked the patients' parents for their observations about their children's symptoms. This assessment was repeated four weeks after the injury occurred.

In the study, the researchers also collected saliva from each participant and analyzed for levels of different microRNAs. They then compared the microRNA profiles to the patient's symptoms at both the initial and follow-up assessments.

The researchers isolated five microRNAs that could accurately identify the participants who would experience prolonged symptoms. These microRNAs could correctly identify if a participant would have prolonged symptoms or not for 42 of 50 participants.

"The microRNAs were able to predict whether symptoms would last beyond four weeks with about 85 percent accuracy," Hicks said. "In comparison, using the SCAT-3 report of symptoms alone is about 64 percent accurate. If you just go off the parent's report of symptoms, it goes down to the mid-50s. In this pilot study, these molecular signatures are outperforming survey tools."

Hicks said predicting the length of concussions as early as possible would help ensure patients get the right care, and advise patients and parents on how long to expect symptoms to continue. For example, if a doctor knew a patient was going to have prolonged symptoms, they might put the patient on medicine right away instead of waiting to see if symptoms clear up on their own.

While more studies are needed, Hicks said he is hopeful that measuring microRNAs in saliva could one day be an accurate, quick way to diagnose and manage concussions.

"The ultimate goal is to be able to objectively identify that a has happened and then predict how long the symptoms will go on for," Hicks said. "Then we can use that knowledge to improve the care that we provide for children who have concussions, either by starting medicine earlier or holding them out of activities for longer."

Explore further: Saliva test predicts prolonged concussion symptoms in children

More information: JAMA Pediatrics (2017). doi:10.1001/jamapediatrics.2017.3884 , jamanetwork.com/journals/jamap … pediatrics.2017.3884

Related Stories

Saliva test predicts prolonged concussion symptoms in children

May 4, 2017
Although most of the 3 million concussions diagnosed in the U.S. each year occur in children, the bulk of clinical guidelines are based on adults. Because of this, pediatricians are limited in how accurately they can advise ...

Know the signs of concussion

August 2, 2017
(HealthDay)—Concussions have been in the news a lot because of health problems experienced by football players, but you don't have to be a professional athlete to suffer this injury.

High-resolution brain imaging could improve detection of concussions

December 1, 2016
High-resolution brain scans analyzed by machine learning algorithms could determine whether a patient has a concussion, according to a new study published in PLOS Computational Biology.

Strict rest may not be best medicine for kids' concussions

December 20, 2016
Strict rest may not be the best medicine for kids with concussions, a Canadian study found, challenging the idea that physical activity should be avoided until symptoms disappear.

Previous mental distress may slow concussion recovery

April 20, 2016
(HealthDay)—Athletes may take longer to recover after a concussion if they had psychosomatic symptoms—aches and pains caused by mental distress—before their head injury, new research suggests.

Assessing concussion symptom presentation may provide insight into rise in rates

July 21, 2017
How physicians and athletic trainers assess symptoms may give insight into why concussion rates are on the rise, say researchers presenting their work at the American Orthopaedic Society for Sports Medicine's Annual Meeting ...

Recommended for you

Inflammation in the womb may explain why some babies are more prone to sepsis after birth

October 9, 2018
Each year 15 million infants are born preterm and face high risks of short- and long-term complications, including sepsis, severe inflammation of the gut, and neurodevelopmental disorders. A new report in the American Journal ...

Dummies not to blame for common speech disorder in kids

October 9, 2018
New University of Sydney research shows bottles, dummies, and thumb sucking in the early years of life do not cause or worsen phonological impairment, the most common type of speech disorder in children.

'Genes are not destiny' when it comes to weight

October 9, 2018
A healthy home environment could help offset children's genetic susceptibilities to obesity, according to new research led by UCL.

Old drug could have new use helping sick premature babies

October 8, 2018
Researchers from The University of Western Australia, King Edward Memorial Hospital and Curtin University are investigating whether an old drug could be used to help very sick premature babies.

Insufficient sleep associated with risky behavior in teens

October 1, 2018
Adolescents require 8-10 hours of sleep at night for optimal health, according to sleep experts, yet more than 70 percent of high school students get less than that. Previous studies have demonstrated that insufficient sleep ...

Checked off 'the talk' with your teen? Not so fast: Once isn't enough

October 1, 2018
Patting yourself on the back for gritting through "the talk" with your kid? Not so fast: new research from Brigham Young University family life professor Laura Padilla-Walker suggests that when it comes to your teens, one ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.