How Technological Advances Could Create Better Tests for Brain Injury, Change Sports Culture

SportTechie| May 17, 2017

At a time when concussions are a primary concern for athletes, a host of different companies and researchers are trying to improve their diagnosis. Over the years, there have been a number of tests for diagnosing and managing concussions, including the widely-used SCAT-3, and of course, the NFL’s concussion protocol. But all of these tests have the same limitation: they are fundamentally subjective.

Concussions, which are a form of traumatic brain injury (TBI), are primarily diagnosed through cognitive testing and the identification of clinical symptoms like dizziness, confusion and memory loss. While those symptoms can be valuable diagnostic tools, they are also nonspecific and can potentially go unreported by athletes who don’t want to get sidelined.

“In some of these sports, there’s almost a culture that you really want to be tough and you really don’t want to remove yourself from the game,” said Kevin Hrusovsky, CEO of the biotechnology company Quanterix. “But if there was an objective test, that could shift the culture of the game.”

One of Hrusovsky’s main goals with Quanterix is to create a concussion diagnosis instrument that can objectively test players on the sideline and quickly tell them whether or not they have a concussion. The appeal is obvious, but it’s a difficult task.

“I think the challenge lies in that this is a functional injury and not a structural injury,” said Teena Shetty, a neurologist at the Hospital for Special Surgery in New York. “Therefore a routine MRI is normal, but the patient is functionally impaired. That makes it more difficult to create a tool which can be administered both quickly and objectively on the sideline and have prognostic value.”

Nevertheless, many companies are striving to create such a tool. Shetty, who is also an unaffiliated neuro-trauma consultant for the New York Giants, can be seen narrating a recent NFL ad that features some emerging concussion technologies, many of which were created by companies that received funding through the league’s Head Health Initiative, a partnership with GE. Among those technologies is Quanterix’s Single Molecule Array, or Simoa, machine.

As the name suggests, the Simoa HD-1 Analyzer is a fully automated instrument that can detect single molecules in a selected fluid. Researchers can hunt for specific molecules by placing vials of blood or other fluids in the machine, at which point Simoa breaks down the fluid and mixes in antibodies and enzymes that will identify the target molecule. It’s the most advanced test of its kind, and Hrusovsky says it’s about a thousand times more sensitive than the traditional technology.

“Our technology allows scientists to see concentrations of proteins almost at the equivalence of a single grain of sand in 2,000 Olympic-sized swimming pools,” Hrusovsky said. “So that shows you just how dilute the concentration could be, and we could pick it up.”

Simoa is considerably advancing the study of concussions because researchers are using it to detect biomarkers — proteins whose concentrations can be indicative of TBI — that were previously undetectable. The most well-known of these concussion biomarkers is a protein called tau.

One of tau’s main functions is to stabilize the skeletal building blocks of axons — the fibers that carry signals throughout the brain. When the brain slams against the skull during a TBI, some of the tau gets dislodged from the axons and enters the surrounding fluid.

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