It’s a familiar scene, and one that plays out on sidelines across the country: An athlete takes a knock to the head and stumbles woozily to the sideline. A concerned trainer or coach trots over and begins asking questions. “What day is it?” “How many fingers am I holding up?” “Who was the last person to score?”
Of course, in this era of heightened concussion awareness, procedures for addressing possible head injuries have tightened up a bit. And yet, concussion diagnosis is still largely based on subjective measures that rely heavily upon athletes to report their symptoms.
A recent study out of the National Institutes of Health shows a new way forward, however. Researchers supported by the National Institute of Nursing Research have found that measuring a particular blood protein could indicate just how long an athlete needs to recover from a concussion. The protein, known as tau, serves as a stabilizing agent in cell structures, but it’s valuable to concussion scientists because it can serve as a biomarker: It acts as a signal that something is wrong and can also reveal the extent of the damage.
Instead of conducting a murky cognitive assessment to determine how badly someone is concussed, a team doctor could theoretically just take a quick blood sample instead, according to a study published in the January issue of medical journal Neurology.
“A blood biomarker has been the holy grail for concussion observation for years,” said Dr. Alison Cernich, the director of the National Center for Medical Rehabilitation Research. “If these findings continue to hold, it could change the management of concussions.”
Observing concussions has traditionally been a very imperfect science.
“As it is now, when we’re looking at [an athlete’s ability to] return to play, it’s based on subjective reporting,” said Dr. Jessica Gill, one of the coauthors of the study. This has proven to be a somewhat problematic approach because, by nature, athletes want to get back on the field as quickly as possible, often at the expense of their physical well-being.
“We want to make them safer,” said Gill. “Those athletes who haven’t fully recovered are at higher risk for more concussions and complications.”
The findings build off a March 2014 study published in the JAMA Neurology medical journal, which found heightened tau levels in concussed professional hockey players. The new NIH study extends those results to collegiate athletes in soccer, football, basketball, and lacrosse. More than 600 athletes at the University of Rochester had their blood tested before their seasons as a baseline for the study, and then anyone suspected to have suffered a concussion was tested again.
If the findings do hold up over further trials, the tau discovery could add clarity to the handling of concussion victims. According to Gill, tau levels in the study were roughly 81 percent predictive of time needed to return to play.
“What’s fascinating is that not only is this a biomarker, but it’s a prognostic biomarker,” said Cernich, whose center is part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, a co-funder of the study.
The newly discovered importance of tau could also influence the way scientists look at other brain afflictions, such as Alzheimer’s and chronic traumatic encephalopathy (CTE), a degenerative disease diagnosed posthumously in dozens of NFL players.
“It really does give us an idea of what some of the things are that we need to pursue going forward,” said Cernich. “It could really be a game changer.”
Alex Frandsen can be reached at firstname.lastname@example.org.