Commentary

Blood simple

On-field tests could soon take the guesswork out of identifying concussions

Originally Published: January 6, 2011
By Shaun Assael | ESPN The Magazine

Concussion Sidebars

• Medication for concussions
• Matt Schaub on concussion awareness
• Reviewing NFL helmet models
• On-field concussion tests
• How a father protects his son
• Congress and concussions

In the not-so-distant future, trainers may not have to rely on baseline testing and sideline questions to diagnose concussions. One pinprick, and an on-the-spot blood test will do.

In Ohio, researchers are zeroing in on a protein called S100B, levels of which are elevated in the blood after a nervous system injury. It is considered to be so reliable an indicator of damage that European insurers already require evidence of it before approving pricey CAT scans. "Brain damage doesn't always manifest right away," says Damir Janigro of the Cleveland Clinic. "If we see this protein is elevated, we know what we're dealing with and can intervene." Janigro hopes for FDA approval by late next fall.

After Week 15, the NFL was on pace for 269 reported concussions this season. That's a 21% rise from 2009 and a 34% jump from 2008. What it's not, necessarily, is bad news. The league says it speaks to players' increased willingness to at least acknowledge the injury. But we won't know for sure until better testing takes the guesswork out of diagnosis and eliminates the possibility of injuries going unreported.

Meanwhile, researchers in Florida are studying a protein called UCH-L1, which is secreted into the blood after the brain receives a trauma. In a clinical study of 66 patients, doctors at Banyan Biomarkers found the worst head injury victims had 16 times more UCH-L1 than uninjured subjects.

Banyan claims its blood test will give a conclusive answer in one minute. An MRI takes 30, not including the time spent carting the player to a locker room.

Banyan will next run a clinical trial of 1,200 trauma patients, funded by the U.S. Department of Defense, to see if the test can turn up evidence of milder injury. "You can't bring a CAT scan machine up a mountain in Afghanistan; that's why the Army is interested," says medical director Jackson Streeter. The firm hopes for FDA approval by 2013.

Taking testing a step further, doctors at the Joint School of Nanoscience in Greensboro, N.C., are designing a handheld device that will search for a half-dozen key proteins -- not just in blood, but in saliva and urine, too. Its targeted rollout is 2014.

By then, a game of X's and O's could be free of concussion X-factors.

Shaun Assael | email

• Senior writer for ESPN The Magazine
• Author of "Wide Open: Days and Nights on the NASCAR Tour"; the New York Times best-selling "Sex, Lies and Headlocks"; and "Steroid Nation"

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