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By Andrea Lewis UM soccer player Payton Agnew’s world was jolted on Oct. 10, 2014. Her memory of that day isn’t crystal clear, but one thing remained in focus: Her season was over. stressing and cognitive measurements using the standard Sport Concussion Assessment Tool, or SCAT3. This is what was used to evaluate Agnew’s recovery. While SCAT3 protocol is among the best, Rau says it’s risky. There can be a huge learning curve where athletes learn to memorize the questions and responses, so it’s not a true, objective measure of recovery. “I took the SCAT3 countless times,” Agnew says when explaining her road to recovery. “I took it enough times I had all the numbers, all the words and questions memorized to where they had to start creating new questions for me.” The research duo joined forces in a quest to develop a clinical lab test for TBI patients that can justly measure recovery before health care providers give the green light to resume normal activity. Their scientific expertise is a great match. Rau is an acute neural injury expert, and Patel is a pharmacology expert. Their meeting of the minds happened somewhat by happenstance, but when the two decided to put their heads together, they saw promising results. So what’s behind the science? Patel explains that by measuring blood-based biomarkers they are measuring micro-ribonucleic acid, or RNA, which are very small pieces of nucleic acid that very powerfully regulate how proteins are expressed in the body. “What we’ve found with our work is following injury there is an increase of these micro-RNA molecules in the blood of the patients,” Patel says. Their hard-hitting data caught the eye of two high-profile companies – the National Football League and General Electric Co. – which are investing in leading research to improve the safety of athletes, members of the military and society overall. In January 2014, the team’s seed money was running out. The researchers were preparing to pack up their offices when they got word they had been selected as one of 16 winners in the first stage of GE/NFL’s Head Health Challenge I. They received The Montana Grizzlies were clad in pink that day in honor of breast cancer awareness. Their opponent was the University of Idaho. Agnew, a redshirt sophomore from San Diego, entered the game. She hadn’t even touched the ball when her teammate got a free kick. Agnew, being tall, moved into the box, and her teammate kicked it directly to her. Agnew leapt for the header. Unfortunately her opponent did the same with elbows out, came crashing down onto Agnew and rammed an elbow into her face. Her memory of what followed is spotty. She lay on the field, unable to move. UM trainers mobilized and immediately took Agnew off the field and out of the game. Her eyes were extremely sensitive to light, her balance was off and a wave of nausea washed over her. She’d experienced these symptoms before. She was certain she had a concussion. What wasn’t certain was the severity of her mild traumatic brain injury. Two UM researchers in the Skaggs School of Pharmacy are working to change that. Research Assistant Professors Sarj Patel and Tom Rau have made some exciting discoveries, which they hope will lead to a test that can definitively measure whether someone has a mild TBI, assess its severity and objectively measure recovery from the injury. When Agnew was taken off the field, her trainers ran her through the Glasgow Coma Scale, which is a subjective measure of level of consciousness based on response to various stimuli. “When you get into mild concussions, or TBI, it’s very difficult for the Glasgow Coma Scale to pick up real subtle differences in a patient,” Rau says. “So, there has been a movement in the field of diagnostics to assess mild patients in an objective manner.” And that’s exactly what their research team is doing. The group includes senior staff scientists Diane Brooks, Eric Wohlgehagen and Fred Rhoderick, as well as physical therapy Assistant Professor Alex Santos. They are working to develop a biomarker in the blood that indicates how the brain reacts following a traumatic brain injury. “Ultimately we want to say, ‘OK, this person did have a concussion and six weeks later is completely recovered,’” Rau says. Currently, recovery is assessed using neuropsychological measures – which largely are based on the intelligence of the individuals. Even though patients can pass the tests, they may not be fully recovered. UM Intercollegiate Athletics employs the ImPACT model, which is a series of assessments that involve cardiovascular Vision 2016 17PDF Image | Carbon Vision 2016
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