Concussion Research: Doctors discover biological markers in saliva

2/6/2023

Concussions can be extremely dangerous, and getting the right treatment as soon as possible is critical to recovery, especially for children’s developing brains. But concussions can be difficult to assess in kids, who often have trouble articulating their symptoms.

While most kids will recover from a concussion within a few weeks, about a third will experience persistent symptoms, like memory issues and headaches, that can last for months and have profound impacts on their lives. A Nationwide Children’s Hospital study has discovered biological changes in the saliva of children who are more likely to need extra time and care to recover.

The saliva test is an objective assessment that can be added to existing concussion testing like questionnaires in the future. Scientists plan to expand on this research and say that it may eventually lead to saliva samples being collected on the sidelines after a concussion so that doctors can predict the child’s risk for prolonged recovery and develop the most effective treatment plan possible.

“If we can detect children who might be at risk of experiencing persistent post-concussion symptoms, their doctor can develop an individualized treatment plan to help them recover sooner and to ensure they are ready to return to their regular activities,” said Dr. Ginger Yang, a principal investigator with the Center for Injury Research and Policy at Nationwide Children’s Hospital and senior author of the study. 

For the study, doctors with Nationwide Children’s Division of Sports Medicine collected saliva samples from children diagnosed with a concussion in the emergency department. Those samples were then analyzed by scientists in the Institute for Genomic Medicine, who examined molecules called microRNAs.

“In that tube of saliva, we can identify more than 800 different microRNAs. Then we use technology in our lab to measure the amount of each of those microRNAs at initial treatment and again at two and four weeks after their injury,” said Dr. Katherine Miller, a principal investigator in the Institute for Genomic Medicine at Nationwide Children’s and lead author of the study.

Using this method, scientists identified 13 microRNAs that are expressed differently in children who experienced persistent post-concussive symptoms.

“That’s important because if we can identify that at the time of injury, it can lead to earlier clinical intervention and a more personalized approach for caring for these children as they recover from concussion, especially if they’re at risk for extended or prolonged recovery,” Miller said.

Having a non-invasive test that gives clinicians biological information on a child’s projected recovery can help them develop recovery plans catered to each patient’s unique needs.

“It is critical that we develop objective measures for diagnosis and prognosis of concussion, as there is potential overlap between that diagnosis and so many others,” said Dr. James MacDonald, a physician for Nationwide Children’s Division of Sports Medicine and principal investigator of the study. “Having this information can help us better assess the needs of each patient and ensure that we are making the most informed recommendations possible to prevent any long-term issues.”

The saliva test is an objective assessment that can be added to existing concussion testing like questionnaires in the future. Scientists plan to expand on this research and say that it may eventually lead to saliva samples being collected on the sidelines after a concussion so that doctors can predict the child’s risk for prolonged recovery and develop the most effective treatment plan possible.

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