The prevalence of concussions in contact sports has become a
common theme. For example, the NFL is in the middle of a legal battle with
former NFL players who claim to have a lower quality of life due to concussions
acquired during their playing careers (Associated Press 2014). With the recent concern over concussions,
it is not surprising that research is geared towards determining a possible time
frame for the return of concussed athletes to the playing field.
Previous research from the University of Pennsylvania showed
that higher blood concentrations of αII-Spectrin N-terminal fragment (SNTF) is
found in patients with mild traumatic brain injuries (mTBI), which are also
known as concussions. SNTF is undetectable in healthy human brains and is only
produced when nerve cells in the brain begin to die (Siman 2013). A new research project
involved the same researchers from the University of Pennsylvania in
collaboration with researchers at the University of Gothenburg in Sweden to
determine if blood concentration of SNTF can be used as a viable marker for the
return of concussed athletes (Siman 2014).
The researchers looked at blood that was drawn from 45
Swedish professional hockey players prior to and throughout the 2012-2013
hockey season. Of the 45 players, 28 had a concussion during the season while
17 had no symptoms of
concussions. 8 of the 28 concussed players were symptom
free within a few days compared to 20 players that had concussion symptoms lasting
6 days or longer. High SNTF levels correlated with the players who had persistent
concussion symptoms and these players did not return to the ice until they were
able to pass concussion protocols. From the incident of the concussion until
the return to the ice, the 20 players with persistent concussion symptoms had
elevated SNTF levels. These results show that the concentration of SNTF may be
used as a future diagnosis and prognosis for sports-related concussions and may
also determine if players are healthy enough to return to action (Siman 2014).
Further research is needed to determine if SNTF levels can
actually be used as a biomarker for the return of a concussed athlete since the
sample size in this study is very small; however, it is a great starting point
in determining when to allow a concussed athlete return to action without
specifically relying on concussion protocols.
References:
Associated Press. [2014 Jul 7]. Federal judge approves NFL concussion settlement [Internet]. NFL web site [cited in 2014 Dec 1]. Available from:
Siman R, Giovannone N, Hanten G, Wilde EA, McCauley SR, Hunter JV, Li X, Levin HS, Smith DH. 2013. Evidence that the blood biomarker SNTF predicts brain imaging changes and persistent cognitive dysfunction in mild TBI patients. Frontiers in Neurology. 4(190): 1-8. Available from: http://search/ebscohost.com/.
Siman R, Shahim P, Tegner Y, Blennow K, Zetterberg H, Smith DH. 2014. Serum SNTF Increases in Concussed Professional Ice Hockey Players and Relates to the Severity of Post-Concussion Symptoms. Journal of Neurotrauma. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25419578.
Image from: http://www.athletico.com/services/neurological-rehabilitation/head-injury-and-concussion-management/
Hi Charlie-- This is a very interesting and relevant topic, especially with what just happened to the Ohio State football player who had a history of concussions. Were you able to find anything about the SNTF levels in players with repeated concussion? I am curious about how the SNTF levels would be in athletes who have gotten more than one concussion. Also, are there any noticeable characteristics corresponding to the slower return to normal function in the group of players showing symptoms for over 6 days?
ReplyDeleteIt is interesting that this biomarker, SNTF, can be detected in systemic blood circulation. I guess it must be small enough to pass through the blood-brain barrier after an injury occurs. This is definitely relevant research for the NFL as a recent PBS Frontline episode discussed how 76 of the 79 brains of former NFL players examined at the Boston University’s Chronic Traumatic Encephalopathy (CTE) Center had CTE. It will be interesting to see if future studies looking at SNTF levels are capable of determining a specific amount of SNTF that indicates it is safe for an athlete to return to play or if the levels can indicate if long term neural damage has occurred like in the cases of athletes with CTE.
ReplyDeletehttp://www.pbs.org/wgbh/pages/frontline/sports/concussion-watch/76-of-79-deceased-nfl-players-found-to-have-brain-disease/