Biofluid biomarkers of concussion: One size does not fit all
Nitin K.Sethi, Associate Professor of Neurology
Published 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.
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.