A saliva test could predict how long children’s concussion symptoms will last

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A simple saliva test may soon be used to test children for concussions and predict how long their symptoms may last, according to a small study published this week in the journal JAMA Pediatrics.

After a concussion, changes can be observed in the saliva of children, which could allow tests to identify specific microRNA’s associated with unique symptoms.

Based on their findings, the team says concentrations of these five microRNAs can be useful to pinpoint individuals with prolonged concussion symptoms with more than 85% accuracy. This is significantly more accurate than assessments relying only on symptoms at four weeks after an injury, according to Jeremiah J. Johnson and colleagues from Pennsylvania State University.

While approximately two-thirds of concussions in children or teens largely resolve themselves within two weeks, lead author Dr. Steve Hicks says one-third may experience prolonged symptoms.

“It’s frustrating for both parents and physicians that we can’t accurately and objectively predict how long a child’s concussion symptoms might last, what those symptoms are likely to consist of and when it might be safe for them to return to sports or school,” said Hicks.

The team says a saliva test would also improve on clinical assessments which face problems with administering “multiple age-specific questionnaires” during individual evaluations.

For the study, lead author Dr. Steve Hicks and colleagues asked 52 participants between the ages of 7 and 21 to spit into a cup. The average age of the patients was 14, and most had been injured in sports or car accidents. Of the 52 participants, 30 had prolonged symptoms experienced prolonged symptoms, while 22 had short-term symptoms of a concussion.

After evaluating the saliva, the team says the levels of the five microRNAs found in the spit were clearly associated with the severity and persistence of long-term symptoms. Additionally, three of the microRNAs were closely associated with specific symptoms, such as headache, fatigue, and memory difficulties.

“Fortunately, the technology required to measure saliva RNA is already employed in medicine; we use it to check patients for upper respiratory viruses in our hospitals and clinics every day,” Hicks said. “Modifying this approach for patients with concussions could potentially provide a rapid, objective tool for managing brain injury.”

While an editorial accompanying the study calls the findings “an advance in the science of sport-related concussions”, experts say it will take time and larger follow-up studies to confirm whether a saliva test could be an effective way to test for long-term concussion symptoms on a wide scale.

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