{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:03:26Z","timestamp":1790744606177,"version":"4.1.0"},"reference-count":65,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,10,4]],"date-time":"2020-10-04T00:00:00Z","timestamp":1601769600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR002015"],"award-info":[{"award-number":["KL2 TR002015"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002014"],"award-info":[{"award-number":["UL1 TR002014"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical &amp; Translational Med"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early, accurate diagnosis of mild traumatic brain injury (mTBI) can improve clinical outcomes for patients, but mTBI remains difficult to diagnose because of reliance on subjective symptom reports. An objective biomarker could increase diagnostic accuracy and improve clinical outcomes. The aim of this study was to assess the ability of salivary noncoding RNA (ncRNA) to serve as a diagnostic adjunct to current clinical tools. We hypothesized that saliva ncRNA levels would demonstrate comparable accuracy for identifying mTBI as measures of symptom burden, neurocognition, and balance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This case\u2010control study involved 538 individuals. Participants included 251 individuals with mTBI, enrolled \u226414 days postinjury, from 11 clinical sites. Saliva samples (n\u00a0=\u00a0679) were collected at five time points (\u22643, 4\u20107, 8\u201014, 15\u201030, and 31\u201060 days post\u2010mTBI). Levels of ncRNAs (microRNAs, small nucleolar RNAs, and piwi\u2010interacting RNAs) were quantified within each sample using RNA sequencing. The first sample from each mTBI participant was compared to saliva samples from 287 controls. Samples were divided into testing (n\u00a0=\u00a0430; mTBI\u00a0=\u00a0201 and control\u00a0=\u00a0239) and training sets (n\u00a0=\u00a0108; mTBI\u00a0=\u00a050 and control\u00a0=\u00a058). The test set was used to identify ncRNA diagnostic candidates and create a diagnostic model. Model accuracy was assessed in the na\u00efve test set.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A model utilizing seven ncRNA ratios, along with participant age and chronic headache status, differentiated mTBI and control participants with a cross\u2010validated area under the curve (AUC) of .857 in the training set (95% CI, .816\u2010.903) and .823 in the na\u00efve test set. In a subset of participants (n\u00a0=\u00a0321; mTBI\u00a0=\u00a0176 and control\u00a0=\u00a0145) assessed for symptom burden (Post\u2010Concussion Symptom Scale), as well as neurocognition and balance (ClearEdge System), these clinical measures yielded cross\u2010validated AUC of .835 (95% CI, .782\u2010.880) and .853 (95% CI, .803\u2010.899), respectively. A model employing symptom burden and four neurocognitive measures identified mTBI participants with similar AUC (.888; CI, .845\u2010.925) as symptom burden and four ncRNAs (.932; 95% CI, .890\u2010.965).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Salivary ncRNA levels represent a noninvasive, biologic measure that can aid objective, accurate diagnosis of mTBI.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ctm2.197","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T06:37:02Z","timestamp":1601879822000},"source":"Crossref","is-referenced-by-count":54,"title":["Diagnosing mild traumatic brain injury using saliva RNA compared to cognitive and balance testing"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9579-6798","authenticated-orcid":false,"given":"Steven D.","family":"Hicks","sequence":"first","affiliation":[{"name":"Department of Pediatrics Penn State College of Medicine  Hershey 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