Concussion Detecting

[ericschand]

Looks like someone has found a way to detect concussions and related brain damage. Even though in the preliminary stages, FDA support makes me wonder.

Armageddon question: Could this end sports leagues like the NHL and NFL?

Something that could relatively quickly determine a concussion and long lasting brain damage would have a severe effect on the players and their long-term playing ability. What team(s) would be keep someone with known brain injury around, especially in the litigation happy USA?

Not to mention how could you keep a child in sports, knowing they are already suffering from damage, and have more to come?

Think-of-the-kids question: If you can detect it, should you be required to pull a child out of sports if they have symptoms?

It's not just hockey and football. Boxing/MMA/wrestling/rugby/AFL, and to an extent, basketball too.

ers

PS. Thrown into the "Off topic" forum but could belong in "Other sports"?

[Knut]

No.. you have Drain Bamage

[4X4]

I'm glad my kid is a girly girl that has no interest in contact sports (taekwondo notwithstanding). If I had a boy, I'd be very hesitant to let him play football or even hockey. I know I got my bell rung a few times, just playing minor hockey. I like to think I don't have brain damage, but my posting history might say otherwise.

[TheSutterDynasty]

I can't find any studies discussing Banyan blood markers specifically but only a mention that they involve glial fibrillary axial proteins (GFAP) among others. Here's a 2017 study discussing some blood markers under different terms.

https://www.ncbi.nlm.nih.gov/m/pubmed/28170122/

CONCLUSION: A single serum concentration of GFAP, UCH-L1, or S-100β within 6 hours of head injury may be useful in identifying and stratifying the severity of brain injury in emergency department patients with head trauma, but cannot reliably exclude a diagnosis of concussion. A positive GFAP was associated with the presence of concussion.

So those markers specifically have a high specificity but low sensitivity. In other words, positive tests reliably diagnose concussions but negative tests don't rule them out. The other issue may be having to administer them within 6 hours. How much does reliability decrease after that time?

It will be interesting to learn more. We have good diagnostic criteria clinically for concussions right now but it requires frequent pre screening.

Edit:

In a statement announcing the approval, the F.D.A. said that the brain trauma indicator was able to predict the presence of intracranial lesions on a CT scan 97.5 percent of the time, and those who did not have such lesions 99.6 percent of the time.

From the NY times.

The more I read it and other studies the more it seems sensationalized. Here is a 2015 review discussing the need for CT scan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860826/

This study discusses two very simple methods (that are already being used) to suggest if an intracranial lesion will be found on CT (the exact same goal? of this blood marker testing), NOC and CCTHR, with both having high specificity/sensitivity already, and, more importantly, they are 100% sensitive for neurosurgical lesions (those requiring intervention).

So this doesn't seem to be adding a whole lot more to our existing diagnostic ability.

[TheSutterDynasty]

Originally Posted by ericschand

Looks like someone has found a way to detect concussions and related brain damage. Even though in the preliminary stages, FDA support makes me wonder.

Armageddon question: Could this end sports leagues like the NHL and NFL?

Something that could relatively quickly determine a concussion and long lasting brain damage would have a severe effect on the players and their long-term playing ability. What team(s) would be keep someone with known brain injury around, especially in the litigation happy USA?

Not to mention how could you keep a child in sports, knowing they are already suffering from damage, and have more to come?

Think-of-the-kids question: If you can detect it, should you be required to pull a child out of sports if they have symptoms?

It's not just hockey and football. Boxing/MMA/wrestling/rugby/AFL, and to an extent, basketball too.

ers

PS. Thrown into the "Off topic" forum but could belong in "Other sports"?

A lot of your questions are somewhat irrelevant as this testing is short term only. From the article:

While a test to diagnose concussions quickly will be welcomed in the medical and sports worlds, it does not address the growing worries about the cumulative effect of repeated head hits. Head hits absorbed over many years of playing football and other sports have been linked to chronic traumatic encephalopathy, a degenerative brain disease found in autopsies of former football players, other athletes and soldiers.

And besides, we already have good clinical testing (called the SCAT test) that uses symptoms (memory/coordination changes, etc) to diagnose concussions. It's not perfect but a potential blood marker test won't be either. Some concussions will be missed, maybe some diagnosed erroneously.