Monday, November 27, 2017

Saliva Biomarkers May Help Predict Post-Concussion Syndrome in Youth

Biomarkers in saliva may help identify youth who are likely to take more time to recover following a concussion, according to a study published in JAMA Pediatrics.

Steven Hicks, M.D., Ph.D., and colleagues at Penn State College of Medicine found that measuring the salivary levels of five microRNAs (miRNAs)—small, noncoding RNA molecules that influence protein production throughout the body—can identify children with post-concussion syndrome (PCS) with about 85% accuracy. In comparison, the Sport Concussion Assessment Tool (SCAT3), the tool currently used to determine PCS, was about 65% accurate.

“The miRNAs associated with PCS have potential utility as a toolset for facilitating concussion management,” Hicks and colleagues wrote. “This tool could ease parental anxiety about expected symptom duration. An objective PCS tool could also inform clinical recommendations about return-to-play and school-based accommodations.”

Hicks and his team took saliva samples and performed SCAT3 assessments on 52 youth aged 7 to 21 who had recently had a concussion. The participants were re-evaluated with SCAT3 after four weeks, and patients with symptom scores of 5 or more were designated as having PCS; 30 of the participants met the criteria for PCS.

The researchers analyzed over 400 miRNAs from the patient saliva samples and identified 15 miRNA that were expressed differently among youth with and without PCS. With additional analysis, the researchers narrowed in on a set of five miRNAs (miR-320c-1, miR-133a-5p, miR-769-5p, let-7a-3p, and miR-1307-3p) that proved the most accurate at distinguishing patients with PCS from patients whose symptoms resolved.

In addition, elevated levels of three miRNAs were individually associated with specific PCS symptoms. MiR-320c-1 was associated with memory difficulty, miR-629 was associated with headaches, and let-7b-5p was associated with fatigue.

“To our knowledge, no single biomarker or biomarker panel has demonstrated adequate test characteristics to be widely used as an objective measure for diagnosing or monitoring recovery from a concussion or for predicting those who are at highest risk for a prolonged recovery,” wrote William Meehan III, M.D., and Rebekah Mannix, M.D., M.P.H., in an accompanying editorial. “If validated in larger, multisite clinical trials, using this salivary microRNA panel to diagnose and manage concussions could be a major advancement to the field.”

For related information, see the Psychiatric News article “Could Changes in Tau Predict Recovery Following Sport-Related Concussion?

(Image: iStock/skynesher)


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