Saliva RNA biomarkers predict concussion duration and detect symptom recovery: a comparison with balance and cognitive testing

• DOI: 10.1007/s00415-021-10566-x
• Publication Date: 2021-05-24T11:03:07Z
• Authors: Gregory Fedorchak; Aakanksha Rangnekar; Cayce Onks; Andrea C. Loeffert; Jayson Loeffert; Robert P. Olympia; Samantha DeVita; John Leddy; Mohammad N. Haider; Aaron Roberts; Jessica Rieger; Thomas Uhlig; Chuck Monteith; Frank Middleton; Scott L. Zuckerman; Timothy Lee; Keith Owen Yeates; Rebekah Mannix; Steven Hicks
• Keywords: Balance problems; Cognitive test

The goals of this study were to assess the ability salivary non-coding RNA (ncRNA) levels predict post-concussion symptoms lasting ≥ 21 days, and examine ncRNAs identify recovery compared cognition balance.RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8-24-years-old) with mild traumatic brain injury (mTBI). Initial ≤ 14 days post-injury, follow-up post-injury. Computerized balance cognitive test performance assessed at initial time-points. Machine learning used define: (1) a model employing ncRNA persistent (PPCS) post-injury; (2) symptom recovery. Performance models against validated clinical prediction rule, balance/cognitive performance, respectively.An algorithm using age 16 predicted PPCS greater accuracy than tool demonstrated additive combined utility (area under curve (AUC) 0.86; 95% CI 0.84-0.88). did not differ between non-PPCS groups (p > 0.05). Follow-up identified similar 11 age. A (ncRNAs, balance, cognition) most accurately (AUC 0.83-0.89).ncRNA biomarkers show promise for tracking mTBI, predicting who will have prolonged symptoms. They could provide accurate expectations recovery, stratify need intervention, guide safe return-to-activities.