Abstract
The purpose of this study was to evaluate the relationship between neuroendocrine hormones and clinical recovery following sport-related concussion (SRC). Ninety-five athletes (n = 56 male, n = 39 female) from a cohort of 11 interuniversity sport teams at a single institution provided blood samples; twenty six athletes with SRC were recruited 2–7 days post-injury, and 69 uninjured athletes recruited prior to the start of their competitive season. Concentrations of seven neuroendocrine hormones were quantitated in either plasma or serum by solid-phase chemiluminescent immunoassay. The Sport Concussion Assessment Tool version 5 (SCAT-5) was used to evaluate symptoms at the time of blood sampling in all athletes. Multivariate partial least squares (PLS) analyses were used to evaluate the relationship between blood hormone concentrations and both (1) time to physician medical clearance and (2) initial symptom burden. A negative relationship was observed between time to medical clearance and both dehydroepiandrosterone sulfate (DHEA-S) and progesterone; a positive relationship was found between time to medical clearance and prolactin. Cognitive, somatic, fatigue and emotion symptom clusters were associated with distinct neuroendocrine signatures. Perturbations to the neuroendocrine system in athletes following SRC may contribute to initial symptom burden and longer recovery times.
Highlights
The purpose of this study was to evaluate the relationship between neuroendocrine hormones and clinical recovery following sport-related concussion (SRC)
As symptom reporting and recovery time following SRC are inexorably tied to the underlying pathobiology of injury, it is only through a greater understanding of this relationship that improvements to treatment will arise
There were no significant differences in age and time from last concussion between healthy athletes and athletes with SRC
Summary
The purpose of this study was to evaluate the relationship between neuroendocrine hormones and clinical recovery following sport-related concussion (SRC). With respect to neuroendocrine function, chronic pituitary dysfunction is the most frequently observed abnormality following mTBI; up to 37% of patients show evidence of hypopituitarism at one to five years post-injury, typically characterized by Variable Age (years) Sex (n, % male) Sport (n, %) Baseball Basketball Field Hockey Football Ice Hockey Lacrosse Mountain Biking Rugby Soccer Volleyball Water Polo Total Symptoms Symptom Severity Days to blood sample from injury Days to medical clearance Concussion History (n, %) Time since last concussion (years). Prior observations of elevated blood levels of thyroid stimulating hormone (TSH) and triodothyronine within 48 h of an mTBI suggest that the hypothalamic-pituitary-thyroid axis may be disrupted acutely after injury In view of this, Merchant-Borna and colleagues[21] found perturbations in peripheral messenger RNA related to the hypothalamic-pituitary-adrenal (HPA) axis in the subacute phase (7 days) after sport concussion. In a study of 14 youth hockey players with SRC, abnormally low (
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