Blood Markers May Guide Return to Play After Concussion

Professional hockey players with concussion showed increased levels of blood biomarkers

(RxWiki News) Even though a concussion is a somewhat common sports-related injury, it's still a very serious injury. It's important for athletes on the mend from a head injury to take it slow.

New research suggests that certain markers in the blood may guide doctors as they work with athletes on a plan to get back in the game after a concussion.

The research team, who studied more than 200 professional hockey players, found that measuring levels of proteins in the blood may help determine when it’s safe for players to get back on the ice after a concussion.

"Take time to recover from a concussion before returning to sports."

Pashtun Shahim, MD, of the Department of Psychiatry and Neurochemistry at the University of Gothenburg in Sweden, co-authored this study.

Dr. Shahim and team set out to analyze blood biomarkers associated with sports-related concussions.

These researchers examined 288 professional ice hockey players from 12 teams playing in the Swedish Hockey League during 2012-13.

Before the season started, all of the players went through an examination to set a baseline, and 47 players gave blood samples.

During the nearly five-month season, 35 players got concussions, with 28 undergoing repeated blood sampling in the days after the concussion through their return to play.

A concussion is a brain injury in response to a head injury. Symptoms of concussion include headache, neck pain, nausea, ringing in the ears, dizziness and fatigue.

Using the blood samples, Dr. Shahim and colleagues measured total tau, a protein essential to brain neuron function and associated with conditions like Alzheimer’s disease.

Another blood measure considered in this study was level of s-100 calcium-binding protein B, a brain protein also associated with degenerative brain disorders.

Dr. Shahim and colleagues found that players who got a concussion had elevated levels of total tau and s-100 calcium-binding protein B.

The preseason measure of tau averaged 4.5 picograms/milliliter compared to a post-concussion measure of 10 picograms/milliliter.

The average preseason measurement of s-100 calcium-binding protein B was 0.045 micrograms/liter, compared with a post-concussion measure of 0.075 micrograms/liter.

Dr. Shahim and team concluded that sports-related concussion may be monitored using these two blood biomarkers.

This study was published online in the JAMA Neurology.

In an accompanying editorial in the same journal, Joshua Gatson, PhD, and Ramon Diaz-Arrastia, MD, PhD, called this research by Dr. Shahim and team an “important contribution” in measuring tau levels in blood.

“This is an important finding, as tau is a widely studied brain-specific molecule involved in a wide range of neurodegenerative conditions. … Total tau may be useful as a prognostic biomarker, as there was a good correlation between total tau elevations one hour after concussion and the number of days it took for symptoms to resolve.”

Funding for this study was provided by grants from the Swedish Medical Research Council.

Four of the study's authors disclosed financial interest in a United States patent application for tau as a brain injury biomarker.

Review Date: 
June 9, 2014