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New tool to determine when athletes can resume sports after concussion may be available soon

Researchers and a biotechnology company are working toward making a test more readily available for clinicians to detect the protein tau in patients with brain injuries. Such a test would more accurately determine when athletes with head injuries can return to the playing field.

“With tau, you’re looking for grains of sand in an Olympic-size swimming pool, so it’s a little more complicated than what’s currently in clinical practice,” Jessica Gill, RN, PhD, of the National Institute of Nursing Research, told Healio Family Medicine. “It’s a little bit different than what’s at a hospital, where you would run something like a C-reactive protein level, or cholesterol, so it’s going to take a little more time until we can do this type of test in clinical practice.”

Gill and colleagues used Simoa (Quanterix), a tool that, according to the company, uses single molecule measurements to access previously undetectable proteins in blood, advancing and accelerating disease diagnoses and treatment.  

“The device traps and seals individual immune-complexes on magnetic beads in thousands of femtoliter sized wells in arrays on Simoa Dics. Each disk contains 216,000 of these wells and each only has enough space for exactly one magnetic bead, enabling Simoa’s ulta-sensitivity and specificity,” Kevin Hrusovsky, Quanterix CEO, told Healio Family Medicine. “The platform is fully automated. After inserting samples of blood (or saliva, cerebral spinal fluid, sweat or exhaled breath condensate) and setting a few parameters, users will receive results in about an hour.”

Gill and colleagues and found a connection between an elevated plasma tau concentration and sports-related concussions, suggesting the tau level could provide an objective tool in determining an athlete’s return-to-play (RTP) time. She said there’s currently no consistent, reliable test available to help determine when a concussed athlete can resume athletic activities.

“We really need an objective biomarker that says it’s safe for an athlete to go back in and play,” Gill said. “Right now [without Simoa] you’re getting a lot of subjective reporting from the parent, the athlete, the coach and there’s a lot of problems with the interpretation of those symptoms. They’re highly variable per individual, and they’re hard to interpret. Having something objective would give us a better ability to make that decision.”

To help explain tau’s significance, Gill and colleagues compared tau levels of 43 college athletes with a sports-related concussion, with those of 37 athletes who did not have a concussion and 21 healthy non-athletes. Blood samples were taken from the 80 athletes during the preseason, then again at 6 (n = 67), 24 (n = 61), 72 (n = 62) and 168 (n = 60) hours after injury. RTP data were available for 41 athletes with a concussion.

The researchers reported that after taking an athlete’s sex into consideration, participants with long RTP had higher tau concentrations overall (P = .022) at 6 (P < .01), 24 (P < .01), and 72 hours (P = .02), when compared with the athletes with short RTP. In addition, receiver operator characteristic analyses showed that higher plasma tau 6 hours post-sports-related concussion was a significant predictor of an RTP of more than 10 days later (P = .01).

Gill said more work must be done on both the research and development fronts.

“It’s us doing these studies, as well as many other researchers to make sure this finding means something and is relevant to clinical practice and the technology catching up to have these machines highly available in places where athletes would come in.”

Hrusovsky said the company is “…striving to have a partnership in place to enable a concussion test be offered in calendar year 2017.”  

Recent research has suggested although concussion guidelines recommend removal from play following injury, 38% of youth athletes return to play same day, leaving them at risk to worsening symptoms.   – by Janel Miller

Disclosures: The researchers report no relevant financial disclosures. Hrusovksy works for Quanterix.