The Lab: “Identification of Blood Biomarkers of Mild Traumatic Brain Injury in Collegiate Football Players”

ABSTRACT

Football has one of the highest incidence rates of mild traumatic brain injury (mTBI) compared to other contact sports, but on field identification relies on sub-optimal subjective assessments.

PURPOSE: We aimed to characterize changes in blood biomarkers of mTBI in NCAA Division I football players in response to repeated head-impacts during a competitive season.

METHOD: We studied 30 collegiate football players (21 linemen; 9 non-linemen). Resting serum samples drawn prior to pre-season camp, at the end of pre-season camp, and at the end of the competitive season, were analyzed for biomarkers of mTBI including S100B, GFAP, NSE, UCHL1, NFL, and BDNF by ELISA. The frequency and magnitude of game and practice head-impacts were recorded using helmet-accelerometers. Changes in serum biomarkers of mTBI between linemen and non-linemen across the different timepoints were analyzed by repeated measures ANOVA. When significant differences were found, Pearson’s correlation coefficients were used to determine linear correlations between biomarkers of mTBI and the frequency and magnitude of head impacts.

RESULTS: All players had similar levels of S100B before the start of the season (pre-camp, p>0.05), however linemen exhibited higher levels of S100B than non-linemen after camp and at the end of the season (post-camp; 30.6%, post-season: 22.5%; p<0.05). While both linemen and non-linemen had greater levels of serum BDNF and NSE at the end of the season, when compared to pre- and post-camp levels (p<0.05), the largest increases were seen amongst linemen (p<0.05). In the linemen group, the average magnitude of head impacts across the 2 weeks of pre-season camp was positively correlated with serum BDNF (r=0.806, p=0.009). The increase in serum S100B observed in linemen at the end of the season was highly correlated with both maximum (r=0.794, p=0.011) and average gyroscopic forces (r=0.669, p=0.049) experienced by players between the post-camp and post-season timepoints.

DISCUSSION: Linemen exhibited a greater increase in serum biomarkers of mTBI than non-linemen where repeated low-moderate head-impacts are less frequent. Furthermore, S100B was highly associated with the frequency and magnitude of head-impacts during a college football season, suggesting a potential role as diagnostic tool for mTBI in contact sports.

RESEARCHERS

Eunhan Cho1; Lemoine, Nathan1; Bailey Theall1; Amy Turner 1; Marucci, Jack1; Mullenix, Shelly1; Calvert, Derek1; Irving, Brian A.1,2 FACSM; Johannsen, Neil M.1,2 : Spielmann, Guillaume 1,2

REFERENCE

Cho, E., Lemoine, N., Theall, B., Turner, A., Marucci, J., Mullenix, S., & Johannsen, N. (2019). Identification of Blood Biomarkers of Mild Traumatic Brain Injury in Collegiate Football Players: 2648 Board# 312 May 31 11: 00 AM-12: 30 PM. Medicine & Science in Sports & Exercise, 51(6).