Saliva test predicts prolonged concussion symptoms in children
PAS Meeting Updates
SAN FRANCISCO – Although most of the 3 million concussions diagnosed in the U.S. each
year occur in children, the bulk of clinical guidelines are based on adults. Because
of this, pediatricians are limited in how accurately they can advise families about
how long a child may suffer symptoms such as headaches, fatigue and trouble concentrating
that can interfere with school and other activities.
New research being presented at the 2017 Pediatric Academic Societies Meeting, however,
suggests a simple saliva test may yield more answers. Investigators will present an
abstract of the study, “Peripheral microRNA patterns predict prolonged concussion
symptoms in pediatric patients,” on Saturday, May 6 at 9 a.m. at the Moscone West
Micro ribonucleic acids (miRNAs) are genetic molecules, chiefly found within cells,
that help regulate protein production. Previous studies have found altered miRNA levels
in the saliva of children with mild concussions. This mirrored similar miRNA changes
in cerebrospinal fluid, which cushions the brain and spinal cord, of patients with
severe brain injury.
Researchers at Penn State College of Medicine studied 50 children between the ages
of 7 and 18 years with mild traumatic brain injury. Spit samples were collected and
tested for miRNA levels. In addition, concussion symptoms were evaluated through parent
and child Sports Concussion Assessment Tool (SCAT-3) surveys, a standardized tool
commonly used to evaluate injured children for concussion and to guide clinical decision-making.
The surveys were taken within 14 days of injury and again four weeks post-concussion.
The 29 children with prolonged concussion symptoms had higher scores for headaches,
fatigue and difficulties concentrating.
Steven Hicks, M.D., Ph.D., FAAP, lead author of the study, said the salivary miRNA
levels were significantly more effective than evaluations using SCAT-3 survey in predicting
which children would continue to experience headaches, fatigue, concentration difficulties
and other concussion symptoms that lasted longer than 4 weeks. Results showed the
standard survey to be less than 70% accurate in identifying children who would have
prolonged concussion symptoms, he said. In comparison, he said, miRNA in saliva correctly
predicted whether concussion symptoms would remain present for at least a month nearly
90% of the time.
“We believe that saliva-based RNA testing holds great promise as an accurate and non-invasive
method for evaluating pediatric concussions and giving patients and families a more
solid prognosis,” Dr. Hicks said.
The Pediatric Academic Societies (PAS) Meeting brings together thousands of individuals
united by a common mission: to improve child health and well-being worldwide. This
international gathering includes pediatric researchers, leaders in academic pediatrics,
experts in child health, and practitioners. The PAS Meeting is produced through a
partnership of four organizations leading the advancement of pediatric research and
child advocacy: Academic Pediatric Association, American Academy of Pediatrics, American
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