10 ms·

Concussion in sport: Saliva test is 94% accurate in rugby union trial

99 points by mrtedbear 6y ago

EMM_386 6y ago
The actual science involved: "The test measures expression levels of 14 small noncoding RNAs in saliva, including microRNAs. “MicroRNAs are messages the cells transmit in response to an event, like a brain injury,” Belli tells The Guardian. “The place where you find microRNAs most abundantly is saliva. Salivary glands are connected directly to the brain by nerves. We’re seeing this response within minutes of injury.” https://www.the-scientist.com/news-opinion/simple-spit-test-could-diagnose-concussions-68591 https://www.the-scientist.com/news-opinion/simple-spit-test-...
- bluecalm 6y ago
  It would be very interesting to see if those markers persist hours/days after the injury as well. Any data on it? I am interested in how much long term damage there is and if that can be detected.
- gpvos 6y ago
  Thanks, I wondered how it could work. This should have been in the BBC article.
yread 6y ago
Why doesn't BBC link to the actual paper: https://bjsm.bmj.com/content/early/2021/02/09/bjsports-2020-103274 https://bjsm.bmj.com/content/early/2021/02/09/bjsports-2020-... Results: The HIA process confirmed concussion in 106 players (HIA+) and excluded this in 50 (HIA−). 32 sncRNAs were significantly differentially expressed across these two groups, with let-7f-5p showing the highest area under the curve (AUC) at 36–48 hours. Additionally, a combined panel of 14 sncRNAs (let-7a-5p, miR-143-3p, miR-103a-3p, miR-34b-3p, RNU6-7, RNU6-45, Snora57, snoU13.120, tRNA18Arg-CCT, U6-168, U6-428, U6-1249, Uco22cjg1,YRNA_255) could differentiate concussed subjects from all other groups, including players who were HIA− and controls, immediately after the game (AUC 0.91, 95% CI 0.81 to 1) and 36–48 hours later (AUC 0.94, 95% CI 0.86 to 1). When prospectively tested, the panel confirmed high predictive accuracy (AUC 0.96, 95% CI 0.92 to 1 post-game and AUC 0.93, 95% CI 0.86 to 1 at 36–48 hours).
- thepangolino 6y ago
  Not linking to the actual paper(s) is sadly an awfully frequent issue with all "science" reporting.
  - OJFord 6y ago
    The journalist who wrote this for the BBC almost certainly didn't even glance at it either, they just wrote up something from Reuters or Associated Press say, which more likely did link the paper. Also, it's not even '"science" reporting', it's "Sport" reporting.
    - lawtalkinghuman 6y ago
      That'd explain it. The science reporters at the BBC almost always link to original studies, but I guess the sport team haven't faced that issue.
  - marshmallow_12 6y ago
    It's not just lazy reporting. It implies a " trust us" attitude, which makes me sad. I want the purest form of truth i can possibly get. If some people are happy to let the BBC [edit: or most news outlets] filter their news for them, i've learnt it's not such a good idea. you end up missing a lot and the truth can be distorted. That is why i highly value HN, we have here professionals reporting on things they know about, HN is a wonderful site, packed with knowledgable people even if the subjects may be limited. I'm glad i found this place. (and i'm sorry if no one else is [edit: that i found it.] I'm trying :).
- EdwardDiego 6y ago
  Because minimal people reading a news website are going to follow that link, I guess. I mean, if you're relying on a news agency to follow scientific news, you're probably not in the population that can easily interpret scientific papers.
  - cldellow 6y ago
ceejayoz 6y ago
The fight to prevent players from receiving these in the NFL and other concussion-heavy sports will be impressive to watch.
- LanceH 6y ago
  It's almost like the NCAA and high school football doesn't exist and concussions wait until the pros.
  - casion 6y ago
    It's possible that is true, or partially so. The strength, speed and pace of play of HS and NCAA is vastly different than the professional level. For any given sport, the any given team is made up of a analogs of the best player in your state in pre-pro levels. Thats a STARK contrast when playing the game.
    - xiphias2 6y ago
      I don't know about rugby, but with skiing/snowboarding I always knew when the season started by just looking at the colleagues.
    - LanceH 6y ago
      There is a bigger differential in skills at lower levels, leading to concussions. There is an order of magnitude more players each step down. There is less professionalism, lower quality gear, no union, and much less supervision each step down. The simple answer is there just isn't the money to chase compared to the NFL. The concussions are happening in both high school and college and are much less likely to get reported.
  - InitialLastName 6y ago
    What, the NCAA give their unpaid interns another opportunity to prove they got hurt while working?
whafro 6y ago
Perhaps this is an important step, but my understanding is that a large share of early-onset dementia is suspected to be caused by head injuries more minor than diagnosable concussions. If we find that conclusively to be the case, this kind of test could in fact be more dangerous than no test at all, as athletes (both adults and children) are cleared to continue play after getting "dinged" but not testing positive with a field-side assay such as the one discussed here. I've always believed that while adults may be able to make their own decisions about risk, children certainly don't have the capacity to choose between looking cool/tough in the moment, having significant cognitive/memory issues in your 30s like my old friend did [0], or worse. Athletes and parents should continue to be concerned. [0]: https://www.inquirer.com/philly/sports/20160805_Sielski__Bryan_Scott_s_story_should_terrify_everyone_who_loves_football.html https://www.inquirer.com/philly/sports/20160805_Sielski__Bry...
- EdwardDiego 6y ago
  But we already have a culture of ignoring head injuries in sports. Rugby, and American Football are only just coming to terms with how dangerous repeated concussions can be. I can't speak for American Football, but for rugby at least, they're trying to take concussion seriously. I say trying, because there's still a large impetus in rugby culture to minimise/deny concussion, even more so since the rules changed to try to prevent repeated concussions - if you have a concussion, you can't play for at least 20 days since symptoms abated (in my country), which can make a real difference in a team's performance in a given season if you're their star fly-half[1]/winger[2] (for Americans, kinda like the quarterback in that those positions often define the plays made). Where I can see this being valuable is in detecting concussions that are either a) subtle enough in symptom to slip past the referee's / team doctor's notice, so picking them up via easy testing can prevent further damage (as a concussion on top of concussion is the worst case scenario) and b) pick up concussions that people are trying to deny because it may harm or hinder the team if they're benched. I can see easy testing for this bringing benefits to both groups a) and b) even if the b's might not be super happy about it. [1]: Highlights of Dan Carter, probably the second best fly-half in rugby history: https://www.youtube.com/watch?v=D3UsOzJuq5M https://www.youtube.com/watch?v=D3UsOzJuq5M [2]: Highlights of Jonah Lomu (RIP), arguably the best winger in rugby history, and an absolute machine: https://www.youtube.com/watch?v=OsXTa7UCGlk https://www.youtube.com/watch?v=OsXTa7UCGlk
andy_ppp 6y ago
Not sure if this is related to all the progress made with testing for COVID (are these both PCR tests?), however it makes me wonder if COVID will lead to the next industrial revolution. I suspect feedback from and eventually alteration of DNA/mRNA will be used to prevent disease, then ageing and then eventually enhance human cognition and other abilities like growing human machine interfaces on the skin...
- deleted 6y ago
  [deleted]
- ceejayoz 6y ago
  To be clear, COVID vaccines have nothing to do with DNA alteration. It's not a form of gene therapy, despite attempts by antivaxxers to claim it is.
  - andy_ppp 6y ago
    It’s not changing your dna but it is using your cell machinery to produce proteins, what is DNA really doing if not that? How long before chemotherapy is produced in your own cells by a genetically modified virus that only infects cancerous tissues. I’m only thinking out loud on this and happy to clarify be told I’m wrong.
IG_Semmelweiss 6y ago
Its nice to see that all those funds raining down on elite athletes may lead to medical innovation. A commercialized concussion test , affordably priced , would make a big impact for amateurs and accident victims alike.
- dmurray 6y ago
  Would it? The recommended response to suspected concussion is the same as if you have confirmed concussion: don't drive yourself home, take a couple of days rest, don't do anything for another week or so that risks getting you another concussion, seek medical attention if things get worse. Importantly, immediate medical treatment is not generally advised. Mostly this test would be useful for ruling out concussion, e.g. letting athletes continue to play contact sports because they "just" got a bang on the head, not a concussion. Hardly a game changer.

99 points by mrtedbear 6y ago

The actual science involved: "The test measures expression levels of 14 small noncoding RNAs in saliva, including microRNAs. “MicroRNAs are messages the cells transmit in response to an event, like a brain injury,” Belli tells The Guardian. “The place where you find microRNAs most abundantly is saliva. Salivary glands are connected directly to the brain by nerves. We’re seeing this response within minutes of injury.” https://www.the-scientist.com/news-opinion/simple-spit-test-could-diagnose-concussions-68591 https://www.the-scientist.com/news-opinion/simple-spit-test-...

bluecalm 6y ago
It would be very interesting to see if those markers persist hours/days after the injury as well. Any data on it? I am interested in how much long term damage there is and if that can be detected.
gpvos 6y ago
Thanks, I wondered how it could work. This should have been in the BBC article.

yread 6y ago

Why doesn't BBC link to the actual paper: https://bjsm.bmj.com/content/early/2021/02/09/bjsports-2020-103274 https://bjsm.bmj.com/content/early/2021/02/09/bjsports-2020-... Results: The HIA process confirmed concussion in 106 players (HIA+) and excluded this in 50 (HIA−). 32 sncRNAs were significantly differentially expressed across these two groups, with let-7f-5p showing the highest area under the curve (AUC) at 36–48 hours. Additionally, a combined panel of 14 sncRNAs (let-7a-5p, miR-143-3p, miR-103a-3p, miR-34b-3p, RNU6-7, RNU6-45, Snora57, snoU13.120, tRNA18Arg-CCT, U6-168, U6-428, U6-1249, Uco22cjg1,YRNA_255) could differentiate concussed subjects from all other groups, including players who were HIA− and controls, immediately after the game (AUC 0.91, 95% CI 0.81 to 1) and 36–48 hours later (AUC 0.94, 95% CI 0.86 to 1). When prospectively tested, the panel confirmed high predictive accuracy (AUC 0.96, 95% CI 0.92 to 1 post-game and AUC 0.93, 95% CI 0.86 to 1 at 36–48 hours).

thepangolino 6y ago
Not linking to the actual paper(s) is sadly an awfully frequent issue with all "science" reporting.
- OJFord 6y ago
  The journalist who wrote this for the BBC almost certainly didn't even glance at it either, they just wrote up something from Reuters or Associated Press say, which more likely did link the paper. Also, it's not even '"science" reporting', it's "Sport" reporting.
  - lawtalkinghuman 6y ago
    That'd explain it. The science reporters at the BBC almost always link to original studies, but I guess the sport team haven't faced that issue.
- marshmallow_12 6y ago
  It's not just lazy reporting. It implies a " trust us" attitude, which makes me sad. I want the purest form of truth i can possibly get. If some people are happy to let the BBC [edit: or most news outlets] filter their news for them, i've learnt it's not such a good idea. you end up missing a lot and the truth can be distorted. That is why i highly value HN, we have here professionals reporting on things they know about, HN is a wonderful site, packed with knowledgable people even if the subjects may be limited. I'm glad i found this place. (and i'm sorry if no one else is [edit: that i found it.] I'm trying :).
EdwardDiego 6y ago
Because minimal people reading a news website are going to follow that link, I guess. I mean, if you're relying on a news agency to follow scientific news, you're probably not in the population that can easily interpret scientific papers.
- cldellow 6y ago

ceejayoz 6y ago

The fight to prevent players from receiving these in the NFL and other concussion-heavy sports will be impressive to watch.

LanceH 6y ago
It's almost like the NCAA and high school football doesn't exist and concussions wait until the pros.
- casion 6y ago
  It's possible that is true, or partially so. The strength, speed and pace of play of HS and NCAA is vastly different than the professional level. For any given sport, the any given team is made up of a analogs of the best player in your state in pre-pro levels. Thats a STARK contrast when playing the game.
  - xiphias2 6y ago
    I don't know about rugby, but with skiing/snowboarding I always knew when the season started by just looking at the colleagues.
  - LanceH 6y ago
    There is a bigger differential in skills at lower levels, leading to concussions. There is an order of magnitude more players each step down. There is less professionalism, lower quality gear, no union, and much less supervision each step down. The simple answer is there just isn't the money to chase compared to the NFL. The concussions are happening in both high school and college and are much less likely to get reported.
- InitialLastName 6y ago
  What, the NCAA give their unpaid interns another opportunity to prove they got hurt while working?

whafro 6y ago

Perhaps this is an important step, but my understanding is that a large share of early-onset dementia is suspected to be caused by head injuries more minor than diagnosable concussions. If we find that conclusively to be the case, this kind of test could in fact be more dangerous than no test at all, as athletes (both adults and children) are cleared to continue play after getting "dinged" but not testing positive with a field-side assay such as the one discussed here. I've always believed that while adults may be able to make their own decisions about risk, children certainly don't have the capacity to choose between looking cool/tough in the moment, having significant cognitive/memory issues in your 30s like my old friend did [0], or worse. Athletes and parents should continue to be concerned. [0]: https://www.inquirer.com/philly/sports/20160805_Sielski__Bryan_Scott_s_story_should_terrify_everyone_who_loves_football.html https://www.inquirer.com/philly/sports/20160805_Sielski__Bry...

EdwardDiego 6y ago
But we already have a culture of ignoring head injuries in sports. Rugby, and American Football are only just coming to terms with how dangerous repeated concussions can be. I can't speak for American Football, but for rugby at least, they're trying to take concussion seriously. I say trying, because there's still a large impetus in rugby culture to minimise/deny concussion, even more so since the rules changed to try to prevent repeated concussions - if you have a concussion, you can't play for at least 20 days since symptoms abated (in my country), which can make a real difference in a team's performance in a given season if you're their star fly-half[1]/winger[2] (for Americans, kinda like the quarterback in that those positions often define the plays made). Where I can see this being valuable is in detecting concussions that are either a) subtle enough in symptom to slip past the referee's / team doctor's notice, so picking them up via easy testing can prevent further damage (as a concussion on top of concussion is the worst case scenario) and b) pick up concussions that people are trying to deny because it may harm or hinder the team if they're benched. I can see easy testing for this bringing benefits to both groups a) and b) even if the b's might not be super happy about it. [1]: Highlights of Dan Carter, probably the second best fly-half in rugby history: https://www.youtube.com/watch?v=D3UsOzJuq5M https://www.youtube.com/watch?v=D3UsOzJuq5M [2]: Highlights of Jonah Lomu (RIP), arguably the best winger in rugby history, and an absolute machine: https://www.youtube.com/watch?v=OsXTa7UCGlk https://www.youtube.com/watch?v=OsXTa7UCGlk

andy_ppp 6y ago

Not sure if this is related to all the progress made with testing for COVID (are these both PCR tests?), however it makes me wonder if COVID will lead to the next industrial revolution. I suspect feedback from and eventually alteration of DNA/mRNA will be used to prevent disease, then ageing and then eventually enhance human cognition and other abilities like growing human machine interfaces on the skin...

deleted 6y ago
[deleted]
ceejayoz 6y ago
To be clear, COVID vaccines have nothing to do with DNA alteration. It's not a form of gene therapy, despite attempts by antivaxxers to claim it is.
- andy_ppp 6y ago
  It’s not changing your dna but it is using your cell machinery to produce proteins, what is DNA really doing if not that? How long before chemotherapy is produced in your own cells by a genetically modified virus that only infects cancerous tissues. I’m only thinking out loud on this and happy to clarify be told I’m wrong.

IG_Semmelweiss 6y ago

Its nice to see that all those funds raining down on elite athletes may lead to medical innovation. A commercialized concussion test , affordably priced , would make a big impact for amateurs and accident victims alike.

dmurray 6y ago
Would it? The recommended response to suspected concussion is the same as if you have confirmed concussion: don't drive yourself home, take a couple of days rest, don't do anything for another week or so that risks getting you another concussion, seek medical attention if things get worse. Importantly, immediate medical treatment is not generally advised. Mostly this test would be useful for ruling out concussion, e.g. letting athletes continue to play contact sports because they "just" got a bang on the head, not a concussion. Hardly a game changer.