Biomarker in Blood May Help Predict Recovery Time for Sports Concussions
Researchers at NIH have found that the blood protein tau could be an important new clinical biomarker to better identify athletes who need more recovery time before safely returning to play after a sports-related concussion.
The study, supported by NINR with additional funding from NICHD, was published online in the Jan. 6 issue of Neurology, the medical journal of the American Academy of Neurology.
Despite the millions of sports-related concussions that occur annually in the U.S., there is no reliable blood-based test to predict recovery and an athlete’s readiness to return to play. The new study shows that measuring tau levels could potentially be an unbiased tool to help prevent athletes from returning to action too soon and risking further neurological injury.
“Keeping athletes safer from long-term consequences of concussions is important to players, coaches, parents and fans,” said NINR director Dr. Patricia Grady. “In the future, this research may help to develop a reliable and fast clinical lab test that can identify athletes at higher risk for chronic post-concussion symptoms.”
Athletes who return to play before full recovery are at high risk for long-term symptoms such as headaches, dizziness and cognitive deficits with subsequent concussions. About half of college athletes see their post-concussive symptoms resolve within 10 days, but in others, the symptoms become chronic.
Tau is also connected to development of Alzheimer’s and Parkinson’s diseases and is a marker of neuronal injury following severe traumatic brain injuries.
In the study, led by NIH Lasker clinical research scholar Dr. Jessica Gill, chief of the NINR brain injury unit, researchers evaluated changes in tau following a sports-related concussion in male and female collegiate athletes to determine if higher levels of tau relate to longer recovery durations.
“Incorporating objective biomarkers like tau into return-to-play decisions could ultimately reduce the neurological risks related to multiple concussions in athletes,” Gill said.
Hearing Loss Prevalence Declining in U.S. Adults Ages 20-69
Hearing loss among U.S. adults ages 20 to 69 has declined over the last decade, even as the number of older Americans continues to grow. These findings, published Dec. 15 in JAMA Otolaryngology–Head & Neck Surgery, also confirm that hearing loss is strongly associated with age and other demographic factors such as sex, race/ethnicity and education. Noise exposure, which is potentially preventable, was also significant but less strongly associated after adjustment for other factors. The research was supported by NIDCD and the National Institute for Occupational Safety and Health.
The researchers found that the overall annual prevalence of hearing loss dropped slightly, from 16 percent to 14 percent, or 28 million adults, in the 1999–2004 period versus 27.7 million in the 2011–2012 period. This decline in absolute numbers was observed despite an increase in the population generally and in the relative number of adults ages 50 to 69 in the more recent time period. The new results are consistent with previous findings showing improvements in hearing over time, when researchers compared NHANES data from 1999 to 2004 with data from 1959 to 1962.
“Our findings show a promising trend of better hearing among adults that spans more than half a century,” said Howard Hoffman of NIDCD’s Epidemiology and Statistics Program. “The decline in hearing loss rates among adults under age 70 suggests that age-related hearing loss may be delayed until later in life. This is good news because for those who do develop hearing loss, they will have experienced more quality years of life with better hearing than earlier generations.”
The researchers do not know the reason why hearing loss prevalence is declining but speculate possible factors could include fewer manufacturing jobs, increased use of hearing protectors, less smoking and advances in health including better medical care to manage risk factors associated with hearing loss.
Early-Phase Trial Shows Shrinkage in Pediatric Neural Tumors
In an early phase clinical trial of a new oral drug, selumetinib, children with the common genetic disorder neurofibromatosis type 1 (NF1) and plexiform neurofibromas, tumors of the peripheral nerves, tolerated selumetinib and, in most cases, responded to it with tumor shrinkage. NF1 affects 1 in 3,000 people. Study results appeared Dec. 29 in the New England Journal of Medicine.
The multicenter phase I clinical trial, which included 24 patients, was led by Dr. Brigitte Widemann of NCI’s Pediatric Oncology Branch, and was sponsored by NCI’s Cancer Therapy Evaluation Program.
The study, conducted at the Clinical Center and three participating sites, took advantage of techniques developed by Widemann’s team that enabled precise measurement of the plexiform neurofibromas. Experiments in mice that developed neurofibromas due to genetic modifications were performed at Cincinnati Children’s Hospital in the laboratory of Dr. Nancy Ratner.
Plexiform neurofibromas develop in up to 50 percent of people with NF1. The majority of these tumors, which can cause significant pain, disability and disfigurement, are diagnosed in early childhood and grow most rapidly prior to adolescence. Complete surgical removal of the tumors is rarely feasible; incompletely resected tumors tend to grow back.
The primary aim of the clinical trial was to evaluate the toxicity and safety of selumetinib in patients with NF1 and inoperable plexiform neurofibromas, and, encouragingly, most of the selumetinib-related toxic effects were mild.