For the NFL, the effort to curb concussions is for high stakes. Now, a handful of companies are working with the league, looking well beyond observable physical symptoms to find better ways to test for the head injuries.
Quanterix is among the companies aiming to bring an objective concussion test to market, as testing is still largely limited to subjective measures like observing eye movement. About 2.5 million emergency room visits were related to traumatic brain injuries in 2010, according to the Centers for Disease Control and Prevention, and early detection can be crucial to limit further damage.
The company hopes to discover not only if individuals have a concussion, but also whether they've suffered past, undetected head injuries. It also hopes to gauge how long sufferers should avoid exertion. The National Football League has channeled money into Quanterix and other concussion treatment companies.
"We're trying to provide real, objective science to this really subjective cognitive world," said Kevin Hrusovsky, CEO of Quanterix.
In 2013, the NFL and General Electric launched the Head Health Initiative, which includes grants awarded to companies developing new tools to diagnose or prevent head injuries. The league — which takes in more than $6 billion annually in television rights revenue alone — made an initial contribution of $30 million to the project.
The efforts come as the NFL aims to reduce concussions, which it says fell by 34 percent in regular season games from 2012 to the end of last season. Researchers have linked repeated head trauma in former NFL players to a degenerative brain disease called chronic traumatic encephalopathy, or CTE.
"If we can recognize those injuries and treat them in a more timely way than we ever had before," that's "going to be positive for the health of the players both short and long term," said Jeff Miller, NFL senior vice president of health and safety policy.
Quanterix received $800,000 in grants in becoming one of six final winners — out of about 400 entries — in the competition. Other grant recipients hope to use blood or imaging-based methods to either identify concussions or study their effects on brain function.
The Quanterix testing machine, originally developed for heart disease and cancer treatment, detects markers in the blood. If individuals suffer a concussion, their brains may release specific proteins that the company tries to identify.
As a condition of the head health competition, technology that was pitched needed to be commercially viable in a "reasonable" amount of time, Miller said. He added that it could take years before the NFL or others actively use the ideas, since some methods would need regulatory approval.
Hrusovsky said clearance for lab companies to use the machines could come as early as next year. He added that a major priority for the company is making its machine smaller so it can be used on the sidelines of games.
Quanterix expects sales to hit $11 million to $12 million this year, and rise to $22 million by next year.
Making a completely objective concussion test could prove "very difficult" for companies, said Chris Nowinski, executive director of the Concussion Legacy Foundation. He noted that the best detection method available currently is about 90 percent accurate. That's about as effective as the Quanterix machine, according to Hrusovsky.
Hrusovsky wants the test to eventually top 99 percent accuracy.
Nowinski added that better detection could help long-term concussion treatment. If used correctly, stronger testing methods could potentially reduce the chances of NFL players, in particular, from suffering chronic brain disease.
"I'm hopeful that proper concussion recognition and management would reduce the risk of CTE," he said.
However, he noted that based on current data, some players may still suffer from CTE even without a hit strong enough that it causes a concussion.