Blood biomarkers could help guide return to play for athletes after concussion


In a recent study it was found that ice hockey players in Sweden with a sports-related concussion had higher levels of the blood biomarker total tau (T-tau), which suggests the central nervous system protein may be a tool for diagnosing concussions and making decisions about when players can return to play.

The study was published recently in JAMA Neurology. Lead author is Pashtun Shahim of Sahlgrenska, University Hospital, Sweden.


According to the authors, concussion or mild traumatic brain injury in athletes who play competitive contact sports, such as ice hockey, American football and boxing, is a growing problem. While mild concussions generally cause no loss of consciousness, they can induce other symptoms such as dizziness, nausea, trouble concentrating, memory problems and headaches. Severe concussions can cause a loss of consciousness. Most concussions resolve in days or weeks, but some patients can suffer symptoms more than a year after injury.


The authors examined whether sports-related concussions were associated with elevated levels of blood biochemical markers of injury to the central nervous system. Swedish Hockey League players (n=288) underwent preseason baseline examination for concussion and some underwent preseason blood testing. Of the 288 players, 35 had a sports-related concussion from September 2012 through January 2013, and 28 of those players were included in the study. Players underwent repeated blood testing in the hours and days after their injuries and when they returned to play.

The authors report that players who had concussions had increased levels of the injury biomarker T-tau compared with preseason levels. The highest levels of T-tau were measured in players during the first hour after a concussion and declined during the first 12-hour period but remained elevated six days later compared with preseason blood results. T-tau levels after concussion also were associated with the number of days it took for concussion symptoms to resolve and for players to safely return to competition.


The authors conclude: “Plasma T-tau, which is a highly central nervous system-specific protein, is a promising biomarker to be used both in the diagnosis of concussion and in decision making as to when an athlete can be declared fit for return to play.”