03.24.21
Data from the SCRUM clinical trial (ISRCTN16974791) have identified a method of diagnosing concussion (mild traumatic brain injury [mTBI]) with 96% accuracy using saliva. The results, published in the British Journal of Sports Medicine, show that specific microRNA salivary biomarkers can be used to indicate a concussion. The SCRUM study was carried out in partnership between the Rugby Football Union (RFU), Premiership Rugby, and Marker Diagnostic
After previous research identified that the concentration of certain microRNAs in saliva changed after mTBI, researchers worked on a 3-year study in elite rugby to determine if those biomarkers could be used as a diagnostic test for sport-related concussion. Saliva samples were tested from 1,028 professional male rugby players. A panel of 14 biomarkers was found to accurately predict concussion as identified on the head impact assessment (HIA) with an area under the curve (AUC) of 0.96 that was also validated with prospective testing against independent data.
Dr Matt Cross, head of Science and Medical Operations at Premiership Rugby, said, “We would like to thank our clubs and all of the players for volunteering to be part of this very important research project. The findings from the study are clearly promising and highlight the potential for salivary biomarkers to further support clinical decision making and the accurate identification and diagnosis of concussion in a range of different sporting and non-sporting settings."
Dr Éanna Falvey, World Rugby chief medical officer, added, “Elite Rugby’s Head Injury Assessment process has proven an invaluable tool in the identification of concussion with an accuracy of over 90%, but we are continually evaluating the latest developments in science and technology to identify potential enhancements. This study, its rigor and outcomes demonstrate the value in a targeted, scientific approach and reflects rugby’s progressive commitment to player welfare.”
The laboratory-based noninvasive salivary biological concussion test can reduce the risk of missing concussions not only in sport but also in settings like military and healthcare. The biomarkers may provide a diagnostic test that is comparable in accuracy to the level of assessment available in a professional sport setting. The concussion test may be used in addition to the existing World Rugby Head Injury Assessment (HIA) protocol.
Matthew C. Varon, MD, and Mazen M. Dimachkie, MD
Jill R. Baron, MD, and Jennifer Villwock, MD
Julia Greenberg, MD; Kaiulani Houston, MD, PhD; Kevin Spiegler, MD, PhD; Sujata Thawani, MD, MPH; Harold Weinberg, MD, PhD; and Ilya Kister, MD
