, 12:185 | Cite as

Metabolomics profiling of concussion in adolescent male hockey players: a novel diagnostic method

  • Mark Daley
  • Greg Dekaban
  • Robert Bartha
  • Arthur Brown
  • Tanya Charyk Stewart
  • Timothy Doherty
  • Lisa Fischer
  • Jeff Holmes
  • Ravi S. Menon
  • C. Anthony Rupar
  • J. Kevin Shoemaker
  • Douglas D. FraserEmail author
Original Article



Concussions are a major health concern as they cause significant acute symptoms and in some athletes, long-term neurologic dysfunction. Diagnosis of concussion can be difficult, as are the decisions to stop play.


To determine if concussions in adolescent male hockey players could be diagnosed using plasma metabolomics profiling.


Plasma was obtained from 12 concussed and 17 non-concussed athletes, and assayed for 174 metabolites with proton nuclear magnetic resonance and direct injection liquid chromatography tandem mass spectrometry. Data were analysed with multivariate statistical analysis and machine learning.


The estimated time from concussion occurrence to blood draw at the first clinic visit was 2.3 ± 0.7 days. Using principal component analysis, the leading 10 components, each containing 9 metabolites, were shown to account for 82 % of the variance between cohorts, and relied heavily on changes in glycerophospholipids. Cross-validation of the classifier using a leave-one out approach demonstrated a 92 % accuracy rate in diagnosing a concussion (P < 0.0001). The number of metabolites required to achieve the 92 % diagnostic accuracy was minimized from 174 to as few as 17 metabolites. Receiver operating characteristic analyses generated an area under the curve of 0.91, indicating excellent concussion diagnostic potential.


Metabolomics profiling, together with multivariate statistical analysis and machine learning, identified concussed athletes with >90 % certainty. Metabolomics profiling represents a novel diagnostic method for concussion, and may be amenable to point-of-care testing.


Concussion Diagnosis Biomarker Metabolomics Adolescents Ice hockey 



We thank Ms. Christy Barreira and Ms. Sandra Shaw for excellent technical support, and Ms. Kathryn Manning and Mr. Kevin Blackney for assistance with data. We graciously acknowledge analytic support from The Metabolomics Innovation Centre at the University of Alberta, Edmonton, AB (Ms. Rupasri Mandal, Ms. Jennifer D. Reid and Dr. David Wishart). This study was supported by the Children’s Health Foundation ( grant to DDF.

Compliance with ethical standards

Conflict of interest

The authors have filed a patent application for metabolomics profiling of central nervous system injury (US Trade and Patent Office No. 62/135886).

Ethical approval

This study was approved by the Human Research Ethics Board at Western University (#103365).

Informed consent

Written informed consent was obtained from the legal guardians and assent was obtained from adolescent subjects.

Supplementary material

11306_2016_1131_MOESM1_ESM.pdf (28 kb)
Supplementary material 1 (PDF 28 kb)
11306_2016_1131_MOESM2_ESM.pdf (7 kb)
Supplementary material 2 (PDF 6 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Mark Daley
    • 1
  • Greg Dekaban
    • 2
  • Robert Bartha
    • 3
  • Arthur Brown
    • 4
  • Tanya Charyk Stewart
    • 5
  • Timothy Doherty
    • 6
  • Lisa Fischer
    • 7
  • Jeff Holmes
    • 8
  • Ravi S. Menon
    • 3
  • C. Anthony Rupar
    • 9
  • J. Kevin Shoemaker
    • 10
  • Douglas D. Fraser
    • 4
    • 11
    • 12
    Email author
  1. 1.Department of Computer ScienceWestern UniversityLondonCanada
  2. 2.Molecular MedicineRobarts Research Institute, Western UniversityLondonCanada
  3. 3.Department of Medical BiophysicsWestern UniversityLondonCanada
  4. 4.Department of Physiology and PharmacologyWestern UniversityLondonCanada
  5. 5.Department of SurgeryWestern UniversityLondonCanada
  6. 6.Department of Physical Medicine and RehabilitationWestern UniversityLondonCanada
  7. 7.Department of Family MedicineWestern UniversityLondonCanada
  8. 8.Department of Occupational TherapyWestern UniversityLondonCanada
  9. 9.Departments of Biochemistry and Pathology and Laboratory MedicineWestern UniversityLondonCanada
  10. 10.School of KinesiologyWestern UniversityLondonCanada
  11. 11.Departments of Pediatrics and Clinical Neurological SciencesWestern UniversityLondonCanada
  12. 12.Paediatric Critical Care Medicine, Children’s Hospital, London Health Sciences CentreWestern UniversityLondonCanada

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