Diagnosing concussion

Spring 2017

With a drop of blood, Dr. Douglas Fraser and a team of researchers are changing the way we diagnose concussion.

In the past decade, rates of reported head injury have increased by more than 40 per cent in children and youth playing football, soccer and hockey. In that same time our understanding of the impacts of concussions has significantly increased.  Concussions can often result in severe symptoms and, in some individuals, long-term neurological dysfunction.  When ignored, these injuries can have lasting consequences.  As a result, concussions are a growing public health concern.

The diagnosis of a concussion can be difficult. Current tests rely on a patient’s description of their symptoms and the judgment of his or her physician. Concussions are sometimes misdiagnosed and some athletes with concussion return to sports too soon, putting them at risk of further injury.

By eliminating the guesswork in diagnosis, London researchers hope to improve patient outcomes.

In a new study, the team developed a blood test that can diagnose concussion in male adolescent athletes with greater than 90 per cent accuracy.

The test uses a small sample of blood drawn from an individual who may have suffered a concussion within 72 hours of the incident. The blood is then analyzed using a form of blood profiling called metabolomics. Scientists measure small molecules in the blood called metabolites, the product of the body’s metabolism, to search for distinct patterns that indicate whether or not a concussion has occurred.

"This novel approach, to use blood testing of metabolites as a diagnostic tool for concussions, was exploratory and we are extremely pleased with the initial results,” says Dr. Fraser, a clinician scientist at Children’s Health Research Institute (a program of Lawson Health Research Institute) and a physician in the Paediatric Critical Care Unit at Children's Hospital, LHSC.

While there have been other attempts to develop a blood test for concussion, this test is unique. Previous attempts have looked for a single biomarker that can distinguish concussed from non-concussed patients. This study took a different approach and investigated a full range of 173 metabolites.

“We looked at all of these metabolites in both concussed and non-concussed patients, and it turns out that the spectrum is really different,” says the study’s co-investigator Mark Daley, a professor in the Departments of Computer Science, Biology and Statistics & Actuarial Sciences at Western University, as well as associate vice president of research at Western. "We did not identify one significant metabolite that can tell us whether or not a concussion has occurred. However, when we look at this broad range of metabolites, we can see clear patterns that allow us to easily distinguish a concussion." 

"The discovery of a blood test that can aid in concussion diagnosis is very important," says Dr. Fraser. "With further research, we anticipate that our blood test will prove accurate with other patient populations."

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