Concussion blood test may soon determine when safe to return to sport, play or work

A BLOOD test could soon determine when athletes, car-crash victims and soldiers are out of the danger zone following concussion and safe to return to work or play, after Melbourne researchers found underlying brain damage can last for at least a month.

While concussion symptoms after mild Traumatic Brain Injury (mTBI) typically disappear within days or weeks, preclinical studies have found that the brain is vulnerable to more serious damage from repeated concussion even 30 days after injury.

Dr Sandy Shultz, a senior researcher from the University of Melbourne’s Department of Medicine at the Royal Melbourne Hospital, said his team was aiming to protect healing brains in two ways through:

DEVELOPING a test to ­measure brain damage independent of concussion ­symptoms; and

PLANS for a trial of the drug sodium selenate — now being tested in human Alzheimer’s patients — that is reducing brain damage in animals after repeated ­concussion.

“There is now emerging evidence that repetitive mild Traumatic Brain Injury can have persisting effects; from the mild effects on memory, language and cognition, through to the chronic traumatic encephalopathy reported in former American footballers,” Dr Shultz said.

They tested the cognition and memory of mice that received multiple mild head injuries five days apart. The more repeated injuries they sustained, the longer they showed deficits over 30 days in cognition as measured through brain scans and blood tests.

“There is a theory this may be due to the repeated injury occurring while the brain is still in a period of increased vulnerability after the first mTBI,” Dr Shultz said. “If that’s the case it becomes very important not just to diagnose the initial injury, but also to determine who has recovered and is no longer in that period of increased vulnerability.

“Current management revolves around presence or absence of symptoms, usually self-reported scales, so this adds more fuel to whether or not current medical or clinical management tools are conservative enough.”

The findings were presented at the Australasian Neuroscience Society’s Annual Scientific Meeting in Hobart. Dr Shultz’s team, which also involves the University of Newcastle, is now using long-term studies of Melbourne amateur football players to identify a biomarker — such as blood or saliva — that could be tested to tell if brain damage still exists, despite concussion symptoms long disappearing.

They have recruited about 40 players from the Melbourne University Blacks Football Club, taking blood samples, brain scans and neuropsychological assessments before the season starts.The eight men who have so far had concussions over the past two seasons repeat these tests at 48 hours, one week, two weeks and one year after injury. They expect to publish their findings at the end of next football season.