A saliva test described by academics as a “game-changer” in the effort to detect concussions in rugby players will be presented to the sport’s governing body next week, in hopes it eventually could be used to diagnose head injuries in all sports.

A study by the University of Birmingham in England, in collaboration with English rugby authorities, saw researchers take saliva samples from 156 players who had head injury assessments during matches in England’s top two divisions in the 2017-18 and 2018-19 seasons.

Using biomarkers within the saliva, the researchers developed a test which could successfully predict the outcome of a HIA in 94% of cases.

The team now aims to collect further samples from players in two elite men’s rugby competitions to provide additional data to expand the test. It will first be presented at a player-welfare symposium run by World Rugby.

“This study, its rigor and outcomes, demonstrates the value in a targeted, scientific approach and reflects rugby’s progressive commitment to player welfare,” said Dr. Éanna Falvey, World Rugby’s chief medical officer, “and we are examining potential next steps.”

Premiership Rugby, which oversees England’s top rugby division, has indicated its willingness to support the next stage of research in the 2021-22 season.


“A non-invasive and accurate diagnostic test using saliva is a real game-changer and may provide an invaluable tool to help clinicians diagnose concussions more consistently and accurately,” said Dr. Valentina Di Pietro, who works at the University of Birmingham and took a lead role in the study.

“In professional sports, this diagnostic tool may be used in addition to current head injury assessment protocols and return to play evaluation to ensure the safety of individuals.”

The team had previously identified that the concentration of specific molecules in saliva changes rapidly after a traumatic brain injury.

Researchers said the test could eventually be used beyond the sports world, for example “in military and healthcare settings,” said Antonio Belli, professor of trauma neurosurgery at the University of Birmingham.

“The differences in the salivary concentration of these biomarkers are measurable within minutes of injury, which means we can make rapid diagnoses,” Belli said.

Additional studies are being undertaken so the test could be expanded to women and young sports players.


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