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    Can salivary microRNA levels identify risk for prolonged concussion symptoms?

    A study in children with mild traumatic brain injury found that concentrations of 5 salivary microRNAs (miRNAs) identified prolonged concussion symptoms with 85% accuracy, suggesting that the answer to this question is “yes.”

    The 52 study participants, who ranged in age from 7 to 21 years, were evaluated for concussion within 14 days of injury, most often resulting from engaging in sports or a car accident. The most common initial reported symptoms were amnesia and loss of consciousness. Investigators measured participants’ symptom burden with a Sport Concussion Assessment Tool (SCAT3), administered either to the patient or his or her parent, at enrollment and again at 4 and 8 weeks later. Those with a symptom score of 5 or higher 4 weeks after injury were considered to have prolonged concussion symptoms (PCS).

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    To evaluate the biomarker potential of salivary miRNAs, investigators collected saliva samples from all participants and assessed yield and quality from extracted RNA. Analysis identified 15 salivary miRNAs associated with PCS with more accuracy than the initial SCAT3 score. Levels of 3 miRNAs were associated with specific symptoms 4 weeks after injury: memory difficulty, headaches, and fatigue, respectively (Johnson JJ, et al. JAMA Pediatr. 2018;172[1]:65-73).

    Thoughts from Dr. Burke

    I wonder if a time will come when we routinely use assays like these to assess recovery after concussion, or even for making a diagnosis of concussion in the first place.


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