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Blood Test Indicates Suitability For Return To Play After Concussion

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New research could help determine the severity of brain injury after sports-related concussion and inform decisions on when an athlete can return to play.

The Penn Medicine study showed that the severity of post-concussion symptoms in professional athletes can be predicted by measuring blood levels of a brain-enriched protein known as SNTF.

This follows previous research by the same group which found that elevated blood levels of SNTF on the day of a mild traumatic brain injury treated in the emergency room predicted those patients who would go on to suffer diffuse axonal injury and long-term cognitive dysfunction.

“We extended this biomarker research to the domain of professional sports to test its merit as an objective and rapid way to determine players´ severity of brain injury,” commented lead author Robert Siman, PhD, Research Professor of Neurosurgery at Penn.

In collaboration with the Sahgrenska Academy at University of Gothenburg, Sweden, the researchers evaluated 28 players in the top Swedish professional ice hockey league who suffered a concussion during the first half of the 2012-2013 season.

Eight of the concussed players were symptom-free within a few days of their injury, but 20 of the players had persistent post-concussion symptoms which meant that they had to withdraw from play for six days or longer. A further 45 players were evaluated during the preseason, 17 of whom were also tested before and after a concussion-free training game.

Results showed that, compared to those players who were not concussed, or whose concussion symptoms resolved rapidly, there was an increase in the blood SNTF concentration from one hour up to 144 hours post-concussion in those players experiencing persisting post-concussion symptoms.

SNTF (calpain-cleaved aII-spectrin N-terminal fragment) is present at undetectable levels in healthy human brains, but is produced under conditions where nerve cells are traumatised and begin to die. Concussions that lead to lasting brain dysfunction cause SNTF to accumulate in vulnerable long axon tracts of the brain, and its blood elevation is a measure of this diffuse axonal injury, Penn Medicine explained.

“These results show that SNTF has promise as a blood biomarker for sports-related concussion and beyond. High blood levels of SNTF appear to identify acute brain damage that corresponds with persisting symptoms after concussion,” the authors of the study said.

Their findings have been published in the Journal of Neurotrauma.