Blood Biomarkers of Sports-Related Concussion in Pediatric Athletes

Abstract

Objective: To examine changes in blood biomarkers, serum neurofilament light (Nf-L), and plasma tau, as well as the relationship between blood biomarkers and symptom reports, in athletes with a sports-related concussion. Design: Prospective cohort study. Setting: Private community-based concussion clinic. Participants: Athletes aged 13 to 18 years old with a diagnosed sports-related concussion presenting to a concussion clinic within 7 days of injury and noninjured athletes with no history of concussion aged 13 to 23 years old. Assessment and Main Outcome Measures: Injured athletes provided a blood sample at the initial clinical evaluation and again at least 6 months after injury. Noninjured athletes provided a single blood sample. All participants completed symptom reports during each visit. Statistical comparisons of biomarker concentrations and symptom reports were conducted. Results: The mean rank for tau was significantly lower for concussed athletes compared with nonconcussed athletes. In contrast, the mean rank of Nf-L was higher for concussed athletes than for nonconcussed athletes, although the difference was nonsignificant. Plasma tau was significantly lower postinjury compared with 6 months after injury, whereas serum Nf-L was significantly higher postinjury. There was a weak but significant inverse relationship observed between tau and the number of symptoms reported, but no relationship was observed between Nf-L and the number of symptoms reported. Conclusions: These data indicate that in the days following a sports-related concussion, the blood biomarkers tau and Nf-L display contrasting patterns of change but may not be related to self-reported symptom scores.

Role of biomarkers and emerging technologies in defining and assessing neurobiological recovery after sport-related concussion: a systematic review

“…Thirty-one papers found changes in blood biomarkers that significantly discriminated between SRC and controls (and/or preinjury baseline levels) 18–48. Similar alterations were found in saliva,49 50 urine,51 52 and CSF53 54 studies.…”

Blood biomarkers of secondary outcomes following concussion: A systematic review

“…Seven studies measured the number of days each participant took to completely recovery from their concussion (36)(37)(38)(39)(40)(41)(42). The remaining three studies investigated whether participants were symptom free at 30 days, 6 months and 12 months respectively (43)(44)(45).…”

“…Six studies investigated the ability of tau to predict recovery duration in both adult and pediatric cohorts. Asken Three studies investigated the relationship between NFL and recovery duration in adult and pediatric cohorts and concluded that there was no significant relationship in either plasma or serum samples (36,37,43).…”

“…et al, Anzalone et al, Hossain et al and Kawata et al all found an insignificant or negligible relationship between tau concentration and recovery duration(36,37,43, 44). Shahim et al combined tau and S100B concentration in ice-hockey players 1 h post-concussion and found a significant correlation with the number of days for symptom resolution(38).…”

Age and Sex Comparisons in Pediatric Track and Field Hurdle Injuries Seen in Emergency Departments of the US

“…This information helps medical providers properly prepare for sporting events and may also play a valuable role in developing injury prevention strategies tailored to specific ages and sexes in individual sports [ 12 , 13 , 17 ]. In summary, even though there are a few studies that have identified both age- and sex-related differences in musculoskeletal injuries [ 18 , 19 , 20 ], there remains no literature to compare potential age- and sex-related differences in hurdle injuries in the pediatric-aged athletic population [ 21 , 22 ].…”