Taking Concussions Head-On: Part II

Recognizing the Breadth of the Problem and the Search for Answers

Previously, I discussed the serious issue of concussions in sports - at all levels - and some of the efforts being pursued to combat it. Much is being done, but one simple and effective path bears further exploration. There may be reason to believe that the secret to diagnosing a concussion could reside in our saliva, offering for the first time an avenue to quickly and accurately provide a definitive diagnosis.

Developing a Spit Test
Long regarded as the sole domain of the dentist, the medical community in recent years has begun to recognize the mouth as a vital gateway to identifying and evaluating overall body wellness. One initiative helping to change this perception is the emergence of salivary diagnostics.

Saliva, it turns out, contains virtually all of the same medical diagnostic information as blood, including DNA, proteins, hormones, metabolites, and inflammatory and immune molecules. In the future, salivary tests may replace certain blood tests as a simple, non-invasive manner of making a diagnosis. Already, saliva is being studied as a tool to diagnose pre-diabetes/metabolic syndrome, oral cancer, active tuberculosis, Lyme disease, and progressive gum disease (periodontitis) to name just a few. The Forsyth Center for Salivary Diagnostics in Cambridge MA, is leading efforts to develop a new generation of point-of-care saliva-based tests.

In the case of a concussion, our spit may able be able to tell us things that blood cannot. At the Forsyth Institute, we're investigating the increase in certain proteins and hormones in saliva following head trauma, and evaluating how these levels may vary over the course of a football season.

The Benefits of a Salivary Test
There are a number of benefits to diagnosing concussion using a salivary test. Most importantly, it could offer a more objective diagnosis compared to cognitive testing, and provide an accurate gauge of when it is safe for a player to resume activity.

  • The test could be administered on the sideline of a game by a person with minimal medical training, as well as in a doctor's office.
  • A positive test would indicate a mild traumatic brain injury, and its definitive read-out would be reason enough to keep the player from returning to action, and to begin a treatment and recovery program.
  • Unlike cognitive tests, which are subjective and can be manipulated, a diagnostic test would be impossible for a player to alter. And insofar as to ensure that a test is not intentionally administered incorrectly, leagues could put strict collection and testing protocols in place to ensure accuracy.

As the 2015 film Concussion depicts the very real consequences of repeated brain injury, now we have an opportunity for the medical community to leverage this spotlight to advance awareness of diagnosis and treatment options - both those already available today and in development. The success of bringing to light a greater understanding of concussions, the short and long -term effects and the importance of proper diagnosis and immediate treatment, is a laudable goal. Supporting that important work with an effective, simple, safe and "unbeatable" saliva test that could detect concussions immediately would go a long distance toward controlling this serious public health challenge.