The issue of concussions has attracted considerable media coverage in recent years. According to the Centers for Disease Control and Prevention, 153 people in the United States die every day from traumatic brain injuries (TBI) that include concussions. Those who survive can face effects that last a few days, or the rest of their lives. Effects of concussions can include impaired thinking or memory, movement, sensation (e.g., vision or hearing), or emotional functioning (e.g., personality changes, depression). In 2013,^[1] about 2.8 million TBI-related emergency department visits, hospitalizations, and deaths occurred in the United States.

In recent weeks, there has been significant coverage of a research study published in the Journal of the American Medical Association titled Association of Salivary MicroRNA Changes with Prolonged Concussion Symptoms. The study investigates a group of children/young adults who suffered a concussion experience and also experienced prolonged symptoms. The authors state:

“To our knowledge, there are currently no objective or easily administered tests for predicting prolonged concussion symptoms. Several studies have identified alterations in epigenetic molecules known as microRNAs (miRNAs) following traumatic brain injury. No studies have examined whether miRNA expression can detect prolonged concussion symptoms (PCS).^[2]”

The research team, from Penn State Medical Center, examined miRNAs as potential biomarkers for predicting the duration and nature of concussion symptoms. The researchers studied 52 children between the ages of 7 and 21 years who had suffered a concussion. They collected salivary RNA using DNA Genotek’s Oragene·RNA, an all-in-one system for the collection, stabilization and transportation of high quality mRNA and miRNA from saliva. The methodology was as follows:

“Participants expectorated into Oragene-RNA RE-100 Expression Analysis Self-Collection Kit. RNA was extracted with Plasma/Serum Circulating and Exosomal RNA Purification Kits. RNA yield and quality were assessed with the Agilent 2100 Bioanalyzer. Sequencing of salivary RNA occurred at the Penn State Genomics Core Facility using a NEXTflex Small RNA Sequencing Kit version 3, a HiSeq 2500 Instrument, and a targeted depth of 3 million reads.^[2]”

They discovered five miRNAs in saliva that could predict with approximately 85% accuracy whether a concussed child would have symptoms one month later. In comparison, standard survey measures that are typically used in clinics were approximately 65% accurate. The researchers go on to state:

“Salivary miRNA measurement may provide an accurate, non-invasive technique for identifying children with PCS. Such information could reduce parental anxiety and improve care for patients by providing a simple tool for concussion management.^[2]”

We congratulate the research team on this very successful project and look forward to learning more as this approach is further validated.

References

[1] Taylor CA, Bell JM, Breiding MJ, Xu L. Traumatic Brain Injury–Related Emergency Department Visits, Hospitalizations, and Deaths — United States, 2007 and 2013. MMWR Surveill Summ 2017;66(No. SS-9):1–16. DOI: http://dx.doi.org/10.15585/mmwr.ss6609a1

[2] Jeremiah J. Johnson, Andrea C. Loeffert, Jennifer Stokes, Robert P. Olympia, Harry Bramley, Steven D. Hicks. Association of Salivary MicroRNA Changes With Prolonged Concussion Symptoms. JAMA Pediatr. Published online November 20, 2017. doi:10.1001/jamapediatrics.2017.3884