25th March 2021

Study suggests that saliva test for concussion in rugby may be possible

A new study suggests that saliva tests for concussion in rugby may be a possibility in the future. The study, published in the British Journal of Sports Medicine, found the presence of specific biomarkers in the saliva of male rugby union players diagnosed with concussion. The test has the potential to provide a clinical test to determine whether a player has suffered a concussion in addition to the current Head Injury Assessment (HIA) protocol used by World Rugby. Due to its clinical nature, it also has the potential to identify concussions that an HIA assessment may have missed.

Heat map representing the average value of the concentrations of the miRNAs across different groups. Hierarchical clustering was performed across groups and miRNAs to check the similar behaviour of the miRNAs. HIA, head injury assessment; MSK, musculoskeletal. Source: BJSM

“In professional sports, this diagnostic tool may be used in addition to current head injury assessment protocols and return to play evaluation to ensure the safety of individuals”, said Dr. Valentina Di Pietro of the University of Birmingham in a statement. Di Pietro is the lead author of the Study, which was carried out in collaboration with England’s Rugby Football Union (RFU), Premiership Rugby, and Marker Diagnostics.

‘The key finding of this study was the identification of a panel of 14 different biomarkers that accurately predicted clinical diagnosis of concussion in professional rugby players’, it reads. ‘The choice of saliva as a non-invasive fluid allows for rapid and well-tolerated pitch-side and post-game collection at very early and specific time points. It is proposed that saliva can receive exosomal miRNAs [Micro RNAs – ribonucleic acid genetic molecules] directly from cranial nerves in the oropharynx, and as such there is a rapid response within saliva after TBI [Traumatic Brain Injury], making them particularly suitable for a pitch-side diagnosis. The development of point-of-care testing for salivary sncRNAs [small non-coding RNAs] would offer the prospect of a test for concussion that can support clinical decision-making in sport.’

Further samples will now be collected from England’s Rugby Premiership and Championship to provide additional data with the aim of expanding the test, so that it can be used to guide prognosis and safe return to play after concussion alongside the HIA process. The findings of the Study will be presented to the World Rugby Laws and Welfare Symposium, which will be hosted virtually from 29-31 March. 

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