Ongoing brain injury evaluation is done by cognitive evaluation by a physician.
The use of on-field saliva testing to diagnose concussion has taken a step forward following a trial of elite rugby players.
The researchers studied 156 Premier League and Championship players who suffered a head injury in the 2017-18 and 2018-19 seasons.
Using microscopic DNA markers in saliva, they have developed a test that predicts a rash of HAI with 94% accuracy.
However, due to lack of data, this test cannot yet be used for women.
Professor Antonio Belli, leader of the study, said it was an opportunity to beat the drum for more research into groups that have traditionally not been counted.
Professor Belli described the results as revolutionary and added: When I see a player on TV take a medical saliva test, it’s a great achievement.
While in the coming months laboratory tests may be used for high-level players, it may be years before we have a pitching test that gives immediate results.
This new technology can be used not only in sports, but potentially in medicine in general and in the military.
What are the results of the study?
The three-year study was conducted by the University of Birmingham in partnership with the Rugby Football Union (RFU), Premiership Rugby and Marker Diagnostics, a company that produces biomarkers.
Dr Simon Kemp, director of medical services at the RFU, described the results as incredibly exciting and said the potential of the test went far beyond rugby.
He was talking about sports: This applies to all head injuries, but in rugby we know that it is possible to detect a change in biomarker very quickly. So we can test in the medical room during the race and, of course, re-evaluate the next day in an elite race.
Belli said the study was a breakthrough and that he had never seen anything so exciting in a field of work that previously relied on blood samples.
He stated: Blood is much harder to manage, and it doesn’t really work on the launch test or kids.
You now have a non-invasive tool that is fairly easy to understand, objective and accurate.
Later stages of the study will focus on brain injury in retired players of contact sports, and Professor Belli is confident that something exciting will emerge soon.
The RFU, the World Rugby Union and the Welsh Rugby Union are facing a lawsuit brought by retired players suffering from incipient dementia.
Can it be used in football?
The Premier League is conducting separate research into the early signs of dementia and is in talks with the University of Birmingham to work on a three-minute rule for concussions.
Saliva testing is performed in the laboratory, but the pace of test development since the Covid 19 outbreak may indicate that the test is developing rapidly.
Professor Belli said concussion biomarkers are present in saliva within minutes of injury and that a three-minute test is theoretically possible.
What about outdoor sports?
Professor Belli highlighted the potential of saliva testing in military conflicts and its importance to the National Health Service.
He said a third to half of brain injuries in accidents can go undetected, adding: The ability to make this diagnosis with a simple test could change the fate of this patient.
And the use of the test can go beyond concussions.
This is quickly becoming an attractive target for liquid biopsies in cancer and heart attacks, as well as other conditions that require normal blood tests, Belli said.
If you can get memory data from a therapist and test children, it opens up several possibilities.
What about concussions in women?
Professor Belli believes that the symptoms in women are more severe and longer lasting than in men, and that it would be incorrect to say that this test would work in women.
Dr Kemp said: We lead the HIA in women’s international play, not the women’s home game. There are real aspirations to change that very quickly, and it would be my personal goal to support that.
The RFU hopes to collect data in the next round of the Women’s Premiership 15, and would also like to do so in the Rugby World Cup, which has been postponed due to Covid-19.
What now?
The final results will be presented at the World Rugby Symposium at the end of this month, with the hope that two more global leagues will join the study to collect data, refine the algorithm and allow for independent verification of the results.
