Point Of Care Detection Of VILIP-1 For On-Field Diagnosis Of Sports-Related Concussion

Abstract

Sports-related concussion (SRC) diagnosis relies on symptom severity and cognitive performance, making it subjective and challenging. PURPOSE: To validate a point of care biomarker, ubiquitinated VILIP-1 (ubVILIP-1), as an objective tool for SRC diagnosis. METHODS: In a double-blind cohort study of 117 D1 football, soccer, and volleyball athletes (82 M, 35F), a lateral flow device was used to detect the presence of ubVILIP-1 with 10 μL of blood. Control biomarker levels were obtained following non-contact activity over multiple seasons at baseline and during early, mid, and late season. A physician diagnosed SRC by clinical exam and the sports concussion assessment tool (SCAT5). Biomarker levels were obtained at 0.5, 2-4, 24, 48, and 72 hrs post-diagnosis and quantified by calibration curves established via recombinant human ubVILIP-1. A Generalized Estimating Equation (GEE) with a log-linear regression mode model (year, sport, sex, study visit: early, mid, late season) was used to determine if ubVILIP-1 concentrations changed over time (P < 0.05). RESULTS: ubVILIP-1 levels do not change significantly over women’s soccer or volleyball seasons, but male players do exhibit a small but statistically significant increase (P = 0.02). There was no significant change in ubVILIP-1 levels between the 2018-19 seasons when controlling for study visit, sport, or sex (P = 0.47). In a small number of athletes (N = 9) diagnosed with SRC, ubVILIP-1 increased within 0.5 hrs of diagnosis (peak concentrations and times post-injury varied based on injury severity) and gradually returned to near normal by 72 hrs. CONCLUSIONS: Levels of ubVILIP-1 do not change with participation in D1 volleyball or women’s soccer athletes, but slight elevations are seen in male athletes over the course of a season. However, there is no significant change in baseline levels between seasons. In concussed athletes, ubVILIP-1 increases from baseline levels within 0.5 hrs and returns to normal within 72 hrs.