Concussion Test May Prove Headache for Some Sports
Oak Lawn, Ill. -- An ultra-sensitive laboratory test that can detect a biomarker for brain injury in the bloodstream of athletes may have a major impact on the future of more violent contact sports like football, hockey and boxing.
Even more significantly, the discovery may aid the continuing investigation of whether repeated concussions and post-concussion syndrome are truly linked to the development of chronic traumatic encephalopathy or CTE, according to a leading neurologist at Advocate Christ Medical Center in Oak Lawn, Ill.
CTE is a progressive, degenerative brain disease that occurs most frequently in athletes who have sustained repeated head injuries and is sometimes referred to as Dementia pugilistica or, more commonly, punch drunk.
In a recent issue of JAMA Neurology, researchers [Shahim et al] reported testing the blood of professional Swedish hockey players who had suffered a concussion during competition and found elevated bloodstream levels of a protein known as tau. Tau helps maintain the integrity of axons – the string-like structures that interconnect brain cells and facilitate communication among cells – much like telephone wires. Axons are located in the brain’s cortex, which is responsible for cognitive thinking and emotion.
Scientists long have known that injury to the brain causes the levels of tau to increase in cerebrospinal fluid, but tapping that fluid to test it every time an athlete, teenager or child sustains head trauma is impractical. Tau protein seems to be strongly associated with CTE and Alzheimer’s disease.
The study showed that a “novel,” highly sensitive immunoassay – a thousandfold more sensitive than conventional lab tests -- could detect changes in the level of tau in the blood and that results of such testing could be used in diagnosing concussion and determining when an athlete can be declared fit to return to play, the researchers said.
What the study does not yet answer is whether repeated insults to the brain are linked directly to development of CTE.
“If the tau protein is a predictor of CTE, then it is reasonable to say that some athletes with elevated levels of tau may never go back to contact sports [following a concussion or series of concussions],” said Dr. Melvin Wichter, chair of neurology and co-director of the Neurosciences Institute at Christ Medical Center.
In the near term, the study “could have a major impact on how we play sports. An athlete who sustains a possible concussion would have a simple blood test done. If the result shows an elevated level of tau, he or she stays out of the game” until tau levels return to normal, Dr. Wichter said. For some athletes, those symptoms might dissipate within a matter of days or weeks. “In 10 percent to 15 percent of cases, symptoms may persist for a year or longer.
“At the 30,000-foot level, however, the study is not simply about whether or not a quarterback can get back into a football game. If blood tau protein is a predictor of CTE, then that fact could change how the more violent contact sports like football, hockey boxing and the martial arts are played. Head injuries could prove too great a liability not only for the athlete, but also for college sports and professional sports organizations,” Dr. Wichter added.
“Lastly, but certainly not least, this blood test may prove to be invaluable in the diagnosis and treatment of Alzheimer’s and related diseases,” he said.
# # #
About Advocate Christ Medical Center Advocate Christ Medical Center is part of Advocate Health Care, which is one of the nation’s leading health care networks. A not-for-profit, 694-bed, premier teaching institution with more than 1,000 affiliated physicians, Christ Medical Center is a leader in health care and one of the major referral hospitals in the Midwest in a number of specialties, including cardiovascular services, heart and kidney transplantation, neurosciences, oncology, orthopedics and women’s health. The hospital also has one of the busiest Level I trauma centers in Illinois providing emergency care for more than 95,000 patient visits annually and is a leader in breakthrough technologies, including eICU® (electronic intensive care unit) monitoring, robotic da Vinci Surgery System® and CyberKnife® Radiosurgery. For the last three years (2012-2014), the medical center has been named to the Truven Health 100 Top Hospitals® list. U.S. News & World Report has ranked the medical center among the nation’s leading providers for cardiology and heart surgery and for geriatric medicine and ranked it overall as being among the top hospitals in Illinois. The hospital is also recognized by the American Nurses Credentialing Center (ANCC) as a Magnet Center. Magnet status represents the highest honor in the nursing profession. To obtain more information or to visit our newsroom, log on to: www.advocatehealth.com/christ.