Mike Hadden, an athletic trainer at Simpson College, envisions a time when trainers can diagnose when athletes have recovered from concussions with not much more than a cotton swab. Wochit
Mike Hadden will gladly spend this spring driving around central Iowa gathering saliva samples.
It’s the next step in the Simpson College athletic trainer’s quest for better diagnosis and treatment of concussions.
High school soccer teams at Dowling Catholic, Dallas Center-Grimes and Southeast Polk are on board. So is the Iowa Barnstormers arena football team.
Hadden’s study, in its third year under the auspices of the non-profit CTE Hope, is trying to establish whether medical personnel can use a simple spit test to determine when a concussed athlete is safe to resume playing his or her sport.
The non-profit was formed by the family of Zac Easter after the Indianola native suffered for six years with chronic traumatic encephalopathy, a degenerative brain disease caused by head trauma. Easter committed suicide at age 24 in 2015 and donated his brain to science.
Hadden is the chief research office of CTE Hope. The initial phase of his study was paid for by a grant from the Warren County Philanthropic Partnership.
CTE Hope got the results recently from its first round of saliva tests, taken in the fall of 2016. The sample size is too small to draw sweeping conclusions, but Hadden — who hopes his spit test will become a quick and effective way to diagnose concussions — was heartened by the initial findings.
Hadden and his research partner Sue Wilson gathered saliva before the season from football and soccer players at Simpson College, storing it at minus-80 degrees. That was used to establish a baseline of the level of five proteins present in each athletes’ saliva when their brains were free of concussion symptoms. Those proteins have been shown to become elevated when concussions occur.
Three football players were diagnosed with concussions that year, Hadden said. They submitted fresh saliva samples immediately thereafter and then periodically throughout treatment. All the samples were shipped to a Boston laboratory to determine what happened to the protein levels over time.
In two cases, involving a backup tight end and a freshman defensive back, the proteins returned to baseline levels when those players were deemed symptom-free and allowed to play again. In the third, a starting offensive lineman, the protein levels remained high even though he no longer reported concussion symptoms.
“It’s exactly what I expected,” Hadden said Thursday. “He was seeing head impacts in practice. It’s not so much the concussion, it’s these sub-concussive hits. This completely corroborates what (a 2017 Boston University) study showed.”
The BU findings revealed that long-term exposure to blows to the head that didn't create concussion symptoms may be even more traumatic than concussions themselves in leading to CTE.
The practical application of Hadden’s findings could be fewer practice sessions where linemen hit each other. Or more practices in which players wear padded caps over their helmets to help dissipate the force of blows to the head.
But three samples are not enough to draw hard conclusions.
“He could have very well been OK after he returned,” Hadden said of the offensive lineman. “We’re not at the point yet where we can correlate these biomarkers with symptoms.”
The Food and Drug Administration last week approved a blood test that can identify concussions, but saliva samples are much cheaper and easier for medical staff to collect from athletes during competition. Hadden is hoping his research makes that a possibility.
In 2017, Hadden said, there were nine concussed athletes among local football and soccer players in his study. He hopes to have those results back in a month or two.
In the meantime, Hadden wants to expand the number of participating athletes to 500-600 this spring. He is concentrating on football and soccer for now, but would like to include hockey players in his studies at some point.
Hadden and Wilson have been busy collecting the baseline saliva samples. When any participating athlete is diagnosed with a concussion, they are on call to drive out and collect new saliva for the next round of tests.
The Barnstormers, who are just beginning a season that will stretch into June, were eager to help out. Michael Donahue, in his third year as the pro team’s head athletic trainer, has been talking to Hadden about the project. He said John Pettit, the Barnstormers’ CEO, needed no convincing.
“It’s a way of showing that we’re caring about the athletes, being sure that we’re taking care of them so we can provide the data that we need to keep them safer in the future,” Donahue said. “I think balking at the thing would come off as insensitive at this point, with all the research that’s come out of late confirming some of the fears about CTE.”
Barnstormer players provided saliva as part of their preseason physical exams. Donahue said all were happy to do so. Modern football players are much more concerned about the long-term impact of concussions, Donahue said, as compared to a previous generation that would sometimes try to hide head injuries from medical staff.
“If what he finds works out, then it would be a relatively easy way to evaluate someone for a concussion that is less about symptoms and is more about the biological markers that he finds in the saliva,” Donahue said of Hadden’s research. “Having an objective number that we can go off of would be valuable.”
Hadden is happy that some local high schools have signed up for his study. But he’s also had many tell him no, and he doesn’t understand the hesitance.
“The world of concussion diagnostics is right here in central Iowa,” Hadden said.
“And we have schools that aren’t participating. It’s so frustrating.”