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Biofluid biomarkers of concussion: One size does not fit all

  • Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Centersethinitinmd@hotmail.com
Submitted February 14, 2017

I read with interest the article by Gill et al. [1] and the accompanying editorial by Drs. Bendlin and Makdissi. [2] It is unlikely that we will find one ideal biofluid (blood or CSF) biomarker to diagnose sport-related concussion (SRC) or determine readiness for return to play (RTP). In today's era of personalized medicine, one size seldom fits all. A more informed option would be to measure levels of multiple biomarkers such as tau, S100 calcium-binding protein B, and neuron-specific enolase both in plasma and serum for each athlete prior to the start of the season in resting and post-exercise states. [3] The levels obtained would serve as that individual athlete's baseline. After a SRC, the levels would be repeated to help guide and individualize management and RTP decision.

1. Gill J, Merchant-Borna K, Jeromin A, Livingston W, Bazarian J. Acute plasma tau relates to prolonged return to play after concussion. Neurology 2017;88:595-602.

2. Bendlin BB, Makdissi M. Blood-based biomarkers for evaluating sport-related concussion: Back in the game. Neurology 2017;88:512-513.

3. Shahim P, Tegner Y, Wilson DH, et al. Blood biomarkers for brain injury in concussed professional ice hockey players. JAMA Neurol 2014;71:684-692.

For disclosures, please contact the editorial office at journal@neurology.org.

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Neurology | Print ISSN:0028-3878
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