Abstract

The long-term health effects of concussion and sub-concussive impacts in sport are unknown. Growing evidence suggests both inflammation and neurodegeneration are pivotal to secondary injury processes and the etiology of neurodegenerative diseases. In the present study we characterized circulating brain injury and inflammatory mediators in healthy male and female athletes according to concussion history and collision sport participation. Eighty-seven university level athletes (male, n = 60; female, n = 27) were recruited before the start of the competitive season. Athletes were healthy at the time of the study (no medications, illness, concussion or musculoskeletal injuries). Dependent variables included 29 inflammatory and 10 neurological injury analytes assessed in the peripheral blood by immunoassay. Biomarkers were statistically evaluated using partial least squares multivariate analysis to identify possible relationships to self-reported previous concussion history, number of previous concussions and collision sport participation in male and female athletes. Multiple concussions were associated with increases in peripheral MCP-1 in females, and MCP-4 in males. Collision sport participation was associated with increases in tau levels in males. These results are consistent with previous experimental and clinical findings that suggest ongoing inflammatory and cerebral injury processes after repetitive mild head trauma. However, further validation is needed to correlate systemic biomarkers to repetitive brain impacts, as opposed to the extracranial effects common to an athletic population such as exercise and muscle damage.

Highlights

  • Concern regarding the potential negative health impact of concussions and collision sport participation has led to an increased demand to delineate the pathophysiological mechanisms mediating long-term outcomes [1]

  • In this study we identified differences in the systemic biomarker profiles of male and female athletes who sustained multiple previous concussions, and in males who participate in collision sports

  • While the Sport Concussion Assessment Tool 3 (SCAT3) is the most utilized evaluation tool in the sport context, it is a crude measure of cognitive abilities, and we recognize its comparative limitations to more advanced neuropsychological tests. Despite these limitations, our results demonstrate potentially sex-specific systemic inflammatory alterations in athletes with multiple previous concussions, and in males who participate in collision sports

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Summary

Introduction

Concern regarding the potential negative health impact of concussions and collision sport participation has led to an increased demand to delineate the pathophysiological mechanisms mediating long-term outcomes [1]. Blood Biomarkers and Repetitive Head Impacts pathophysiology consists of an acute disturbance of neurobehavioral function together with damage to neuronal and glial cells [2]. Evidence is emerging that suggests concussion, as well as the repetitive head impacts that commonly occur in collision sport participation, may contribute to negative health outcomes such as chronic traumatic encephalopathy (CTE) [9,10,11,12,13,14]. Our current understanding of these pathophysiological processes in humans is limited

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