Abstract
ObjectiveTo compare neurofilament light (NfL) and tau as blood-based biomarkers for acute sports-related concussion (SRC) and determine whether their concentrations at different time points after the injury are associated with prolonged time to return to play (RTP).MethodsA total of 288 professional hockey players were followed longitudinally from September 1, 2012, to April 30, 2015. Data collection and biomarker analyses were conducted between 2015 and 2017. Associations were tested between blood concentrations of NfL and tau, and RTP time. Serum concentrations of S100B and neuron-specific enolase (NSE) were also measured for comparison.ResultsOf 288 players, 105 sustained an SRC. Of these, 87 underwent blood sampling 1, 12, 36, and 144 hours after SRC and at the RTP time point. Serum NfL concentrations 1, 12, 36, and 144 hours after SRC were related to prolonged RTP time, and could separate players with RTP >10 days from those with RTP ≤10 days (area under the receiver operating characteristic curve [AUROC] 0.82). Also, serum NfL 144 hours after SRC discriminated players who resigned from the game due to persistent postconcussion symptoms (PCS) from those who returned to play (AUROC 0.89). Plasma tau 1 hour after SRC was related to RTP but less strongly than NfL, while S100B and NSE showed no such associations.ConclusionSerum NfL outperformed tau, S100B, and NSE as a biomarker for SRC. From a clinical standpoint, serum NfL may be useful to identify individuals at risk of prolonged PCS, and may aid in biomarker-informed decisions with regard to when RTP should be considered.
Highlights
A total of 288 professional hockey players were followed longitudinally from September 1, 2012, to April 30, 2015
Serum neurofilament light (NfL) concentrations 1, 12, 36, and 144 hours after sportsrelated concussion (SRC) were related to prolonged return to play (RTP) time, and could separate players with RTP >10 days from those with RTP ≤10 days
Serum NfL 144 hours after SRC discriminated players who resigned from the game due to persistent postconcussion symptoms (PCS) from those who returned to play (AUROC 0.89)
Summary
A total of 288 professional hockey players were followed longitudinally from September 1, 2012, to April 30, 2015. Data collection and biomarker analyses were conducted between 2015 and 2017. Serum concentrations of S100B and neuron-specific enolase (NSE) were measured for comparison. Study population This is a prospective cohort study of concussion among professional hockey players (n = 288) from 14 teams in the top Swedish Hockey League, who were followed longitudinally from September 1, 2012, to April 1, 2015. Data collection and blood biomarker analyses were conducted between 2015 and 2017. Twenty-eight of the concussed players as well as the preseason values from 2 of the above teams have been previously reported.[14]
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