In the Journals

Blood biomarkers may provide information on impact of concussion in collegiate athletes

Michael McCrea

According to results published in JAMA Network Open, blood biomarkers may provide information on how sport-related concussion impacts the brains of collegiate athletes.

“Results from our study demonstrate that blood biomarkers provide important information on the pathophysiological mechanisms of concussion, or how concussion affects brain processes and function,” Michael McCrea, PhD, ABPP, told Healio Orthopedics. “While this study marks an important step toward understanding the utility of biomarkers in sport-related concussion, much work is yet required before biomarkers are to be used in clinical practice.”

Researchers from the NCAA and the U.S. Department of Defense Concussion Assessment, Research, and Education Consortium identified 264 collegiate athletes with concussion, 138 contact-sport control athletes and 102 noncontact control athletes. All athletes completed clinical testing and blood collection at preseason baseline, in the acute postinjury period, 24 to 48 hours postinjury, the point at which athletes reported they were asymptomatic and 7 days after they returned to play. From March 1 to November 30, 2019, investigators conducted data analysis. The Quanterix Simoa multiplex assay was used to quantify glial fibrillary acidic protein (GFAP), ubiquitin C-terminalhydrolase-L1 (UCH-L1), the neurofilament light chain and tau. The Sport Concussion Assessment Tool-Third Edition (SCAT-3) symptom evaluation, standardized assessment of concussion, balance error scoring system and brief symptom inventory 18 were among the assessed clinical outcome measures.

Results at the acute postinjury period compared with preseason baseline results showed significant elevation in GFAP, UCH-L1 and tau levels in athletes with concussion. Investigators noted a significant interaction was seen between GFAP, UCH-L1 and tau. However, the interaction for the neurofilament light chain was not significant.

In differentiating athletes with concussion from contact sport controls, the area under the curve for the combination of GFAP and UCH-L1 at the acute postinjury period was 0.71. The area under the curve for the acute postinjury period for the four biomarkers combined was 0.72. Apart from the SCAT- 3 symptom score, the GFAP at the acute postinjury period correlated with athletes being classified as either a concussion from contact controls or noncontact sport controls. Significantly higher levels of GFAP were seen in athletes with concussion with loss of consciousness or post-traumatic amnesia compared with athletes with concussion with no loss of consciousness and no post-traumatic amnesia at the acute postinjury period. – by Monica Jaramillo

 

Disclosures: McCrea reports he receives grants from the National Collegiate Athletic Association and the U.S. Department of Defense; receives research funding from the National Institute of Neurological Disorders and Stroke, CDC and the National Football League outside the submitted work. Please see the study for all other authors’ relevant financial disclosures.

 

Michael McCrea

According to results published in JAMA Network Open, blood biomarkers may provide information on how sport-related concussion impacts the brains of collegiate athletes.

“Results from our study demonstrate that blood biomarkers provide important information on the pathophysiological mechanisms of concussion, or how concussion affects brain processes and function,” Michael McCrea, PhD, ABPP, told Healio Orthopedics. “While this study marks an important step toward understanding the utility of biomarkers in sport-related concussion, much work is yet required before biomarkers are to be used in clinical practice.”

Researchers from the NCAA and the U.S. Department of Defense Concussion Assessment, Research, and Education Consortium identified 264 collegiate athletes with concussion, 138 contact-sport control athletes and 102 noncontact control athletes. All athletes completed clinical testing and blood collection at preseason baseline, in the acute postinjury period, 24 to 48 hours postinjury, the point at which athletes reported they were asymptomatic and 7 days after they returned to play. From March 1 to November 30, 2019, investigators conducted data analysis. The Quanterix Simoa multiplex assay was used to quantify glial fibrillary acidic protein (GFAP), ubiquitin C-terminalhydrolase-L1 (UCH-L1), the neurofilament light chain and tau. The Sport Concussion Assessment Tool-Third Edition (SCAT-3) symptom evaluation, standardized assessment of concussion, balance error scoring system and brief symptom inventory 18 were among the assessed clinical outcome measures.

Results at the acute postinjury period compared with preseason baseline results showed significant elevation in GFAP, UCH-L1 and tau levels in athletes with concussion. Investigators noted a significant interaction was seen between GFAP, UCH-L1 and tau. However, the interaction for the neurofilament light chain was not significant.

In differentiating athletes with concussion from contact sport controls, the area under the curve for the combination of GFAP and UCH-L1 at the acute postinjury period was 0.71. The area under the curve for the acute postinjury period for the four biomarkers combined was 0.72. Apart from the SCAT- 3 symptom score, the GFAP at the acute postinjury period correlated with athletes being classified as either a concussion from contact controls or noncontact sport controls. Significantly higher levels of GFAP were seen in athletes with concussion with loss of consciousness or post-traumatic amnesia compared with athletes with concussion with no loss of consciousness and no post-traumatic amnesia at the acute postinjury period. – by Monica Jaramillo

 

Disclosures: McCrea reports he receives grants from the National Collegiate Athletic Association and the U.S. Department of Defense; receives research funding from the National Institute of Neurological Disorders and Stroke, CDC and the National Football League outside the submitted work. Please see the study for all other authors’ relevant financial disclosures.