Date of Award

5-2022

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Mindy Staveteig

Keywords

MicroRNAs; Polymerase chain reaction; Biomarkers; Brain concussion; Saliva; Traumatic brain injury; Fluid biomarkers; TBI; mTBI; Concussion; Head injury; mRNA

Abstract

Upon head trauma, neurons within the brain can become stretched and injured. Continuous mild traumatic brain injuries (mTBIs) without proper healing can lead to chronic neurological symptoms. This is especially problematic in contact sports and military personnel. The purpose of this literature review is to take an in depth look at fluid biomarkers that could aid in the diagnosis of a concussion at a point of injury. Databases were used including PubMed, Clinical Key, Embase and Access Medicine. The studies chosen were published within the last 7 years, applicable to the topic and absent of pronounced bias. The 19 works include clinical trials, randomized control trials, and systematic reviews. There proved to be more research in blood biomarkers than salivary biomarkers, but the evidence is still lacking with both in relation to mTBIs. GFAP and UCHL1 show to be sufficient serum markers for individuals who have a significant concussion history or recurrent head trauma. Additionally, continued research on saliva miRNAs could prove them to be a diagnostic tool for quick, point of injury tests. The data shows that serum proteins respond in a much more delayed response, whereas saliva miRNA biomarkers respond more acutely. Additional studies will need to be done to properly examine both genders, other contact activities, and the polytrauma associated with military personnel.

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