Blood test could take the guesswork out of concussions

By Ben Knight

The debate over concussions in pro sports has never been an easy one, as coaches, managers and executives try to balance player health with the need to have them playing in the game.

But in an intriguing new development, researchers at the Orlando Regional Medical Center in Florida have announced a new way to diagnose concussions: using a blood test.

"It’s something that’s very objective,” says Linda Papa, an emergency physician and the centre’s director of clinical research.

"This would be a nice way of validating symptoms, and being able to give patients an objective measure of the severity of injury they’ve had."

Ongoing debate

Just last month, a federal court in Minneapolis released some 2011 emails from NHL commissioner Gary Bettman.

Bettman, in a conversation on fighting and concussions with deputy commissioner Bill Daly, wrote:

Concussions, in other words, were likely secondary to the possession of certain personality traits in the deaths of former NHL tough guys.

The quote underscores the uncertainty the sports industry faces in diagnosing concussions.

Finding what a CT scan can’t

Papa, a Montreal native with degrees from Ottawa and McGill universities, has identified two specific proteins that are released in the brain during a concussion, which can be detected by using a blood test.

"What we’ve found now is that one of these markers actually goes up really quickly. The other goes up relatively quickly, but sticks around for much longer, and was able to give us diagnostic information, even seven days after the injury."

She underscores the traditional difficulties of diagnosis – which complicate matters when a sports doctor tries to determine if a player has just been concussed.

"In practicing emergency medicine, we see a lot of these patients,” she notes.

"We do a physical examination and a CT scan, but often what happens is the CT scan is normal. We discharge them, and say that if they have problems, they should come back. 70 per cent go home and do just great, but there’s a 30 per cent group that doesn’t do well. They continue to have symptoms and problems, and then they come back to the emergency department, and the CT scan is negative again, and they’re still having problems."

Such a blood test would be invaluable in the emergency room. But would it be able to instantly diagnose concussions in sports?

"That is our intention," she says. "We know that within 15-20 minutes, we can detect these proteins.”

But 15 minutes can be an eternity in sports. Coaches need to know right away whether it is safe to send a player back into action.

"That’s what we are working on right now – the very few minutes right after. The whole idea is to try to get a point-of-care test that could be used in a pre-hospital setting, whether it be on the field or in the ambulance.”

The research continues, but a quick, easy, definitive test for concussions could be just around corner.