Early test targets sports-related concussions a timely subject

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Concussions have garnered much attention in the sports world recently following news about early dementia and other neurological problems after repeated head injuries. Head trauma from sports ranging from professional boxing to high school football and skateboarding are seen as potentially leading to later deficits and the impact need not necessarily be intense nor lead to loss of consciousness to do serious damage. The crux of the problem has been that even when an athlete sustains a blow to the head, there has been no way to accurately assess whether he or she has sustained real brain damage: asking about and evaluating symptoms is a highly subjective measure. So, if a player feels all right, they may go back to the game, risking even more damage.

But, there may now be an elegant, scientific way to tell if a head blow was likely to have resulted in a concussion. A new report published in the journal PLOS One describes a test for a protein using only a drop of blood to predict which players are at risk.

Dr. Karin Kiechle and colleagues reported the results of their investigation into the utility of measuring blood levels of a protein called S100B produced by brain cells as an index of concussion. They studied 46 male athletes, 30 from Munich, Germany, and 16 from Rochester, NY, who participated in collegiate or semi-professional contact sports.

First, they measured blood levels of S100B before the sports season. Then, they measured these levels several times in the 17 athletes who had suffered sports-related injuries (SRC) within 3 hours post injury, and again 2 and 3 days later. In one group the researchers also measured S100B in athletes who had played but had not been injured in order to determine if exertion alone would increase the protein levels.

The results demonstrated that simple exertion had no effect on S100B levels compared to levels measured before the sports season began. In contrast, the proportional S100B levels within 3 hours of injury averaged 89 percent over the baseline levels, a highly significant difference. These levels returned to baseline levels by 2 or 3 days post-injury.

Thus, the authors concluded, early post-SRC testing of S100B levels, when compared to a baseline level, can serve as a reliable marker for concussion. However, they also note that although S100B testing is currently used in Europe to determine the need for a CT scan, it hasn t been approved by the FDA for use in the United States. Also, they state Point of care test devices that require a finger stick sample of blood are currently under development but are not yet available. They suggest Baseline finger stick S100B testing could become integrated into the required pre-participation physical exam that is part of collegiate and secondary sports participation in both the US and Germany.

A simple, reliable test for concussion potential incurred in contact sports would be a real boon to athletes, ACSH s Dr. Gilbert Ross commented. Currently there is no way to accurately assess which head blows will lead to concussion soon after an injury. Further study of this protein marker is obviously warranted in a much larger sample of athletes, he continued.