Healthy Kids    

New saliva test can help kids with concussions



Predicting which children will need more time and care to recover


Predicting clinical recovery of children with concussion is challenging. While concussion symptoms typically resolve within one to three weeks, up to one-third of children develop persistent post-concussive symptoms (PPCS), including headache, nausea, dizziness, blurred vision and sensitivity to light and/or sound. Compared with children without PPCS, children with PPCS are at increased risk of experiencing disruption to their daily routines and functioning, such as missed school days, depressed mood and loss of social activities, leading to lower quality of life.

In a study published in Frontiers in Public Health, researchers with the Center for Injury Research and Policy, Division of Sports Medicine, and the Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital have demonstrated a method by which increased risk of PPCS in children with concussion can be identified. This could allow families and their care teams to better assess recovery time of children with concussion.

“The diagnosis of concussion is based on self-report, and it can be difficult for children, especially those who are very young, to describe their symptoms following injury,” explains senior author Jingzhen Ginger Yang, PhD, MPH, a principal investigator at the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children’s Hospital. “Currently, there are no markers to objectively predict who is going to recover sooner or later. If physicians could identify children at risk for prolonged recovery, they may be able to intervene earlier, providing personalized concussion care, to improve patient recovery.”

Previous research suggests that salivary microRNAs – small molecules that can regulate the amount of specific proteins a cell makes – may serve as potential markers to identify children with concussion who are at increased risk of PPCS. However, no studies have focused specifically on children, and it remains unknown whether and how salivary microRNA expression levels differ over time between children with or without PPCS.

In this study, Dr. Yang and colleagues demonstrated that the expression levels of 13 salivary microRNAs differ over time following concussion in children with versus without PPCS. To identify microRNAs and evaluate their predictive value in children with concussion, the researchers recruited 60 children between 11 and 17 years of age who were diagnosed with a concussion by a physician at Nationwide Children’s. They collected saliva at up to three timepoints (within one week of injury, one to two weeks post-injury, and four weeks post-injury) and participants’ daily post-concussion symptom ratings throughout their enrollment using the Post-concussion Symptom Scale. PPCS was defined as symptoms that persisted at 28 days post-concussion.

“The approach we used for sample collection is very promising because it is noninvasive and easy, for both the investigator and the patient, to collect the sample. The lack of pain and convenience is appealing to families,” explains co-first author James MacDonald, MD, MPH, a physician for Nationwide Children’s Division of Sports Medicine and principal investigator of the study.

The researchers measured expression levels of 827 salivary microRNAs in 135 collected saliva samples. Of the 827 microRNAs analyzed, the team identified 91 that had heightened expression levels, and of those 91 microRNAs, they identified 13 with significantly different expression levels across the three timepoints post-concussion between children with and without PPCS. Among the 13 microRNAs identified by the team, one was also found to have different expression levels between children with and without PPCS in a prior study.

“This research is an excellent example of the team science approach and what can be accomplished with multidisciplinary collaborations,” adds co-first author Katherine Miller, PhD, a principal investigator in the Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s. “The value of our publication is that our findings come from multiple time points. We need more studies like this to continue to track how these microRNAs change over time and hone in on those that are most consistent across patient populations.”

“It is critical that we develop objective measures for diagnosis and prognosis of concussion, as there is potential overlap between that diagnosis and so many others,” said Dr. MacDonald. “Having this information can help us better assess the needs of each patient and ensure that we are making the most informed recommendations possible to prevent any long-term issues.”

The research was supported by Nationwide Children’s Intramural Funding Program awarded to Dr. MacDonald and Dr. Yang and by The Ohio State University’s Discovery Theme Initiative in Chronic Brain Injury.

Reference:
Miller KE, MacDonald JP, Sullivan L, Rao Venkata LR, Shi J, Yeates KO, Chen S, Alshaikh E, Taylor HG, Hautmann A, Asa N, Cohen DM, Pommering TL, Mardis ER, Yang J, on behalf of the NCH Concussion Research Group. Salivary miRNA expression in children with persistent post-concussive symptoms. Frontiers in Public Health. 2022;10:890420.

About The Abigail Wexner Research Institute at Nationwide Children's Hospital
Named to the Top 10 Honor Roll on U.S. News & World Report’s 2022-23 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit free-standing pediatric health care systems providing unique expertise in pediatric population health, behavioral health, genomics and health equity as the next frontiers in pediatric medicine, leading to best outcomes for the health of the whole child. Integrated clinical and research programs are part of what allows Nationwide Children’s to advance its unique model of care. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s faculty train the next generation of pediatricians, scientists and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded free-standing pediatric research facilities in the U.S., supporting basic, clinical, translational, behavioral and population health research. The AWRI is comprised of multidisciplinary Centers of Emphasis paired with advanced infrastructure supporting capabilities such as technology commercialization for discoveries; gene- and cell-based therapies; and genome sequencing and analysis. More information is available at NationwideChildrens.org/Research.



Other articles by HVP News Reporters


  • 4 ways to promote positive maternal mental health

    It's important to take good care of yourself

    The joys of raising and nurturing a baby are practically endless for new parents, yet there remain challenges to overcome. While it may be natural to focus attention and energy on caring for a new baby, it’s equally important for mothers to maintain their own mental health. read more »
  • Foot and ankle safety tips for the summer months

    7 facts you need to know

    From the beach to the backyard, taking care of your feet and ankles in summer is essential. read more »
  • Donate plasma to save lives this summer

    It's a meaningful way to give back to your community

    Plasma donation is an impactful, meaningful way to give back to your community this summer. By donating plasma, you can help people like Machelle Pecoraro. read more »
  • Reinvigorate your plant collection

    Annual Master Gardener Program Great Plant Swap and Sale

    The Annual Cornell Cooperative Extension of Ulster County’s (CCEUC) Master Gardener “Great Plant Swap & Sale” Returns on Saturday, June 10, 2023 at the Forsyth Park Pavilion, 157 Lucas Avenue in Kingston. The proceeds benefit the Dominic Parise Master Gardener Scholarship. read more »
  • 5 garage safety tips

    Make sure everything is secure and functioning properly

    When you throw open the windows, you’ll likely be spending more time with the garage door open, too. Make access to your outdoor equipment safer with these tips to get your garage ready for the warmer months. read more »
  • 7 vegetables to grow easily in your home garden

    All you need is a little time and effort

    Growing fresh, healthy vegetables at home may not be as hard as it sounds. Novice gardeners just need good dirt, easy plants to grow, lots of sunshine and the right amount of water. read more »
  • 7 budget-friendly gardening hacks

    Tricks to help you create a cost-effective garden

    Gardening can be a simple way to beautify your yard, relieve stress and save money on your grocery bill, but like any hobby, you can get carried away buying necessary equipment. read more »
  • 2023 I Love My Parks Day Events

    Volunteer with your family to clean up a local state park

    I Love My Park Day is an annual event that brings together thousands of volunteers to enhance and celebrate New York's amazing parkland. read more »
  • Spinach and artichoke stuffed mushroom caps

    Simple, easy and delicious

    Bringing an element of elegance to your holiday celebration is easy when you start with party-pleasing ingredients, and great tasting food often starts with dairy. read more »
  • Parmesan crusted chicken

    Super easy to make

    Not only is this Parmesan Crusted Chicken dish delicious, it is super simple to make. read more »