tau fragments predict return to play in concussed professional ice hockey

P., Linemann T., Inekci D., Karsdal MA., Blennow K.,Tegner Y., Zetterberg H.,
Henriksen K. Journal of Neurotrauma. Epub ahead of print.

Take Home Message: The
Tau-A biomarker is a potential biomarker to distinguish those at risk for
prolonged recovery following a concussion.

and return to play following a concussion rely heavily on subjective
information from athletes. Thus, there is a great need to develop an objective
tool, such as a blood test, to diagnose and monitor a concussion. Therefore,
the authors evaluated professional Swedish ice hockey players to determine the
utility of 2 fragments of tau, an intracellular
protein in the central nervous system,
(tau-A & tau-C) for diagnosis and
prognosis of sports-related concussions. The authors compared preseason levels
of the tau fragments (47 athletes) to levels 1 hour, 12 hours, 36 hours, and
144 hours after a concussion injury or when the athlete returned to play (28
athletes). Levels of tau-C were higher after a concussion compared with
preseason levels. There were no differences between tau-A serum levels between preseason
and post-concussion levels. Once both tau-A and tau-C peaked the levels
remained the same until return to play. When comparing concussed players that
had symptoms resolution within 10 days to players with persistent symptoms
beyond 10 days serum tau-A at 1 hour and 12 hours were higher in those with
persistent symptoms. There were no tau-C level differences found between players
with symptom resolution within 10 days and those suffering from persistent
symptoms. The authors found that Tau-A levels at 12-hour post concussion had the
highest diagnostic accuracy to discriminate early and late return to play,
where tau-C was not able to discern return to play time between the groups.

authors demonstrated that biomarkers from a blood test following a concussive
event could have diagnostic benefits. The most interesting finding was that
tau-A levels at 1 hour and12 hours post injury could predict which athlete
would return to play within 10 days or later. Measuring tau-A levels could help
identify high-risk concussion cases that should be managed with a higher degree
of attentiveness. Though tau-C levels were higher following concussion, levels
remained the same until return to play. However, tau-C may be used to
discriminate if a player has a concussion or not, but more research is needed. Together
a blood test measuring tau-C and tau-A levels could assist medical
professionals with concussion diagnostic and prognostic accuracy, respectively.
More research is necessary to validate the diagnostic accuracy of tau-A; since
the pre-season and post concussion levels were measured in 2 different groups
of players. However, biomarkers could help establish diagnostic and safe return
to play criteria following a sports-related concussion.

Questions for
Discussion: Do you think a biomarker panel would be a useful concussion tool?
Do you see most of your concussed athletes within 12 hours following injury?

Written by: Jane McDevitt, PhD
by: Jeff Driban


Shahim P, Linemann T, Inekci D, Karsdal MA, Blennow K, Tegner Y, Zetterberg H, & Henriksen K (2015). Serum tau fragments predict return to play in concussed professional ice hockey players. Journal of Neurotrauma PMID: 25621407