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A Method to Quantify Concussions in Athletes

     Concussion awareness has increased dramatically with the ongoing research, public reports, and dissemination of incidents in professional sports. Concussions are a common injury in contact sports and prevalent in ice hockey. Depending on severity, concussed players are taken out of play at the team physicians' discretion for multiple weeks. Concussions are difficult to assess, since quantifying a concussion is challenging. Often players underperform on subjective tests at the start of the season or on initial baseline testing. However, using blood biochemical biomarkers, concussions and the severity of concussions are quantifiable.

     A test study conducted by Shahim et al. in 2014 and published in the Journal of American Medical Association was performed to figure out if biomarkers in the blood could be used to evaluate concussions. The study of 288 Swedish professional hockey players was conducted during the 2012-2013 season using preseason tests of blood biomarkers. Each player underwent standardized tests of concussions before players hit the ice and began regular season play. The players, who did not have concussions, were tested for levels of total tau (T-tau), S-100 Calcium binding protein B (S-100B), and neuron-specific enolase (NSE). These preseason tests set a guideline and control for later, post-concussion studies.

     Throughout the season, players with concussions underwent testing to remeasure T-tau, S-100B, and NSE. The levels of T-tau were significantly higher in the players with concussions than in the players without the concussion, however there was no significant level change in the other tests. T-tau concentrations were used to determine the amount of days it takes until the player could return to play. Based on the study findings, changes in plasma T-tau levels can be used for diagnosis of concussions and determining when players are fit to return to play. The method of measuring plasma T-tau levels provides team physicians, coaches, and players with a quantifiable, non-discriminatory marker of player concussions. In addition, T-tau levels can be used as an indicator of concussion severity, the duration necessary for complete recovery, and a determination on when the athlete can safely return to play.

Written by Ethan Andales with Eric Sternlicht, Ph.D. Chapman University, Orange, CA.


1. Shahim, M.P., Tegner, Y. and D.H. Wilson. (2014). Blood Biomarkers for Brain Injury in Hockey. JAMA Neurol. 71(6):684-692.

2. Journal of the American Medical Association.