A Blood Test for Sports Concussions – Can Americans Stand The Truth?

Posted on | March 28, 2016 | 1 Comment

hu-youth-sports_300x200 Source: CDC

Mike Magee

Two years ago, the Swedish Hockey League made medical history – but not in a good way. 288 members of the 12 teams fighting for the title in their 2012-2013 season agreed to participate in a head trauma medical study. An unfortunate 35 did sustain concussions, and of these 28 completed required blood testing at 1, 12, 36, and 144 hours after injury. In each case, their blood was tested for specialized protein biomarkers. Two of those markers, total tau and S-100 calcium-binding protein B, consistently rose and were confirmed to be associated with acute axonal and astroglial injury. In addition, the level of rise positively correlated with the extent of the injury, and the subsequent recovery of function.

The study was a breakthrough. It proved that traumatic injury of brain cells could be detected by a simply blood test because these injured cells released stress proteins, and these proteins crossed the blood brain barrier and entered the general blood circulation.

Medical science, especially diagnostic medical science, never exists in a vacuum. In the public light of recent documentaries, investigative reports and feature films, the tragic outcomes of NFL players with a history of traumatic injuries has been on full display. And parents of young children and high schoolers in competitive sports of all types have wasted no time raising the question, “Are our children safe, or at least safe enough to take on the risk of participating on a sport team?”

Emergency medicine and sports medicine specialists weighed in with data. About 250,000 children suffer traumatic brain injuries a year, the majority associated with sports. The level of injury is highly variable, and competitive sports associations, in association with sports medicine specialists, have agreed on protocols for on the field evaluation and acute response to injuries. But most have agreed that the evaluative measures (some basic neurologic evaluation and questions to assess balance, level of consciousness and orientation) are a very blunt tool.

But what if there was a blood test that could be administered on the field that could detect significant blunt trauma damage to the brain? Four months ago, an emergency medicine physician, NIH-funded, researcher from Florida reported on the results of just such a test. Dr. Linda Papa and her team described the results of 152 children who had suffered sports related head trauma, and who had received both CT scans and a blood test for glial fibrillary acidic protein (GFAP). Glial cells surround brain neurons, and the protein in released with injury and finds its way into the general circulation.

The blood test was found to corollate with CT findings 94% of the time. In addition, levels of GFAP rose with severity of injury. The researchers left no doubt where they are heading with this. Papa said, “The idea is to get a point-of-care test that could be used on the field, to help the coaches, the trainers and the athletic directors, make a decision then and there about whether the child should go back to play.”

But she may be under-estimating the full impact of this test. Because it is quite likely that the question most of America’s increasingly risk-averse parents will ask is not “whether their child should go back to play”, but rather whether the child should have played in the first place. And it’s also likely that elevations will be a common finding not only in football, but also in a wide range of other sports including soccer, basketball, track and field, gymnastics and many more.