Can saliva testing deliver better diagnosis of concussion?

As part of the Innovation is Alive session at Co:Lab 2024, Dr Indira Basu presented on research underway into improving diagnosis of concussion amongst females, with a focus on those playing contact sports.  

“The research combines knowledge and expertise from sports sciences and pathology,” says Dr Basu, who is Technical Lead, Microbiology/Molecular pathology based at Awanui Labs – Auckland.  

“The team are building on existing research which shows as more females are taking part in contact sports, they can often have more severe and longer symptoms so there is a need for more accurate diagnosis and treatment.”      

Dr Basu is collaborating with a team led by researchers at the AUT Sports Performance Research Institute New Zealand to determine if changes in microRNA in the saliva of female players can also be used to diagnose concussion.  

The study will also examine whether the results will be impacted by their sex-specific hormone levels at various times post-concussion. 

“Concussion is clinically defined as a form of traumatic brain injury caused by direct or indirect force to the head or the body impacting on brain function. It is often associated with contact and collision sports with an increasing awareness on the long-term cognitive consequences for players. 

“Because concussion is a functional rather than a structural injury, recognising when someone is concussed can be difficult, or be overlooked. A person’s symptoms are often subtle and non-specific and undiagnosed and untreated episodes of concussion increase the risk of long-term neurological damage.” 

Dr Indira Basu presents her research at CoLab 2024

Dr Basu says previous studies, mostly with male players, have been undertaken to determine if testing for the changes in the levels of a biomarker called microRNA found in saliva through non-invasive collection method can be used to diagnose concussion. However, head trauma in female players have been underrepresented in concussion research.  

“Research shows certain microRNA are highly enriched within neurons. There is growing evidence showing levels of microRNAs are altered in saliva of individuals with concussion.  

“These microRNA are released from a person’s cranial nerves into the saliva within minutes of impact and can provide a rapid window into the physiology of the injured brain. These miRNAs are in protective vesicles, meaning they are protected and stable, and can be collected through the non-invasive saliva collection method for further testing.”  

The research team will recruit a cohort of female participants, between 16 and 50 years old, who present at hospitals in the Wellington region with a suspected concussion. Their saliva samples will be collected and sent to the laboratory to be tested for distinct types and levels of microRNAs. The study will record and compare the changes in microRNA with variations in each patient’s specific sex-hormone levels at different time points during the recovery time after their concussion.  

Dr Basu says the study is nearing completion and hopefully the results will be available in 2025.  

“Early in October, this year’s Nobel Prize in Physiology/Medicine was awarded for the discovery of microRNA, which plays a crucial role in determining how some organisms, including humans, develop and function and how they sometimes malfunction.  

“The Nobel laureates discovered the microRNAs found in a person’s cells play an important part in a process known as gene regulation. This novel biomarker is being studied extensively also for other neurodegenerative diseases, cancer, and heart diseases to name a few. 

“Our research aims to build on this international evidence and knowledge to support non-invasive saliva sampling as a suitable, reliable, and cost-effective test for diagnosis of concussion, increase accessibility and assist the recovery and health and wellbeing for females across New Zealand,” says Dr Basu.  

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