Saliva DNA test could help diagnose concussion in rugby players, study finds

A saliva test developed to diagnose concussion could be used as part of rugby’s arsenal to tackle head injuries and the resultant neurodegenerative diseases some suffer from.

A study by the University of Birmingham in collaboration with the Rugby Football Union and Premiership Rugby took saliva samples from more than 1,000 Premiership and Championship rugby players.

It identified a method of accurately diagnosing concussion using saliva, paving the way for the first non-invasive clinical test for concussion for use in sport.

The Head Injury Assessment protocol which is currently used in rugby includes a neurological examination, a series of cognitive tests and evaluation of gait and balance to determine if a player has been concussed.

The saliva test would use DNA sequencing and biomarkers to determine if a player is impacted by concussion.

Senior author Antonio Belli, professor of Trauma Neurosurgery at the University of Birmingham, said: "Conducting a study in a professional contact sports setting has meant we have been able to collect invaluable data enabling us to make significant advances in our knowledge and understanding of concussion and its diagnosis.

"Crucially, the differences in the salivary concentration of these biomarkers are measurable within minutes of injury, which means we can make rapid diagnoses."

Author Dr Simon Kemp, the Rugby Football Union’s medical services director, said: "While still a way from having something that can be used in community rugby, it is extremely encouraging to now be able to start to develop a rapid and non-invasive test which could add real value particularly at a grassroots level of the game."

The research notes that concussion can be hard to diagnose, particularly at grass-roots level, where most of it occurs, but where a gold standard assessment by trained clinicians during and after a game isn’t always readily available.

As a result, a high percentage of concussions are missed, and concerns have emerged about the long-term brain health of athletes exposed to repeated concussions.

It is thought that a saliva test could be particularly suitable for a pitch-side diagnosis because saliva can receive cellular signals directly from cranial nerves in the mouth and throat, so can rapidly register traumatic brain injury.

Several former professional rugby union players have launched legal action against World Rugby, the Rugby Football Union and Wales Rugby Union over alleged failures to protect players from the risks caused by concussion.

Dan Scarborough, now 43, is the ninth player to join the legal case. He was diagnosed with a traumatic brain injury, early onset dementia and probable chronic traumatic encephalopathy – a neurodegenerative disease – in December.

Mr Scarborough said: "One of the main drivers for this action, and for speaking out, is to help other former professionals gain access to elite level treatment and deal with injuries sustained throughout our careers, which is effectively cut off once you retire.

"The governing bodies have a responsibility to look after us post-retirement. Yet, prevention is better than cure.

"I knew what it was doing to my body, I just didn’t realise what it was doing to my brain. My biggest issue now is memory loss."

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