A blood test can accurately detect the ongoing effects of a concussion and help determine when a player can return to play, in revelations which could turn heads at the NRL after a nightmare tackle left Queensland poster boy Reece Walsh unconscious.
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The rugby league world is divided over the horror tackle which condemned NSW Blues centre Joseph Sua'ali'i to State of Origin infamy after he was sent off eight minutes into his debut on Wednesday night - and the battle lines are drawn virtually straight across the state line.
The mercurial Maroons fullback is likely to be fit for game two of the series in Melbourne on June 26, but the ongoing effects of concussions have sports officials wary of rushing athletes back into action across a raft of codes.
Monash University-led research conducted with amateur Australian rules players has found a blood test could help to determine when an athlete can return to play safely.
Researchers measured two brain-specific proteins in the blood of 81 Victorian Amateur Football Association players who experienced concussion, and compared them with 56 players who did not.
Blood biomarker levels were tracked over time, allowing researchers to monitor how long it took the players' brains to recover, known as 'neurobiological recovery', to negate an elevated injury risk.
The study centred on two brain cell proteins - glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) - which are released into the blood following brain trauma, tracking how levels changed over time in concussed players.
More than 20 per cent of concussion cases showed substantial and persistent increases in both GFAP and NfL levels, which remained elevated compared to those in non-concussed footballers for more than four weeks.
Researchers say individuals with extreme biomarker changes were substantially more likely to have lost consciousness as a result of a head knock.
"The unique thing about this study is not the measure, but how many times and how consistently we did it - eight times over six months for 137 athletes," study lead and Monash trauma group principal investigator Dr Stuart McDonald said.
"We demonstrated that blood levels of GFAP are elevated in the vast majority of athletes with concussion at 24 hours, and we are now working to have this much-needed diagnostic test approved for use in the next few years.
"The next important step is demonstrating how and when we should measure these two proteins as return to play biomarkers. Our findings take us closer to this becoming a reality.
"Our vision is for serial measures of these proteins to be integrated into clinical care, guiding return to play decisions based on both symptom and neurobiological recovery.
"We do have some good reasons to believe that elevated biomarker levels do indicate that the brain is still in a heightened state of vulnerability to repeated injury."
The findings could have a major impact on local sport, with AFL Canberra already adopting a mandatory minimum 21-day return to play protocol, in line with the Australian Institute of Sport's Concussion and Brain Health Position Statement.
Caden Helmers
Caden Helmers is a sports journalist for The Canberra Times.
Caden Helmers is a sports journalist for The Canberra Times.
