Citation

Meier TB, Huber DL, Bohorquez-Montoya L, Nitta ME, Savitz J, Teague TK, Bazarian JJ, Hayes RL, Nelson LD, McCrea MA. Ann. Neurol. 2020; ePub(ePub): ePub.

Affiliation

Department of Neurology, Medical College of Wisconsin, Milwaukee, WI.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1002/ana.25725

PMID

32215965

Abstract

OBJECTIVE: Prospectively characterize changes in serum proteins following sport-related concussion and determine if candidate biomarkers discriminate concussed athletes from controls and are associated with duration of symptoms following concussion.

METHODS: High school and collegiate athletes were enrolled between 2015 and 2018. Blood was collected at pre-injury baseline and within 6 hours (early-acute) and at 24-48 hours (late-acute) following concussion in football players (n = 106), matched uninjured football players (n = 84) and non-contact sport athletes (n = 50). Glial fibrillary acidic protein, ubiquitin c-terminal hydrolase-L1, S100 calcium binding protein B, alpha-II-spectrin breakdown product 150, interleukin-6, interleukin-1 receptor antagonist and c-reactive protein were measured in serum. Linear models assessed changes in protein concentrations over time. Receiver operating curves quantified the discrimination of concussed athletes from controls. A Cox proportional hazard model determined if proteins were associated with symptom recovery.

RESULTS: All proteins except glial fibrillary acidic protein and c-reactive protein were significantly elevated at the early-acute phase post-injury relative to baseline and both control groups and discriminated concussed athletes from controls with areas under the curve of 0.68-0.84. The candidate biomarkers also significantly improved the discrimination of concussed athletes from non-contact controls compared to symptom severity alone. Glial fibrillary acidic protein was elevated post-injury relative to baseline in concussed athletes with a loss of consciousness or amnesia. Finally, early-acute levels of interleukin-1 receptor antagonist were associated with the number of days to symptom recovery.

INTERPRETATION: Brain injury and inflammatory proteins show promise as objective diagnostic biomarkers for sport-related concussion, while inflammatory markers may provide prognostic value. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en