Abstract
BackgroundInflammation appears to be an important component of concussion pathophysiology. However, its relationship to symptom burden is unclear. Therefore, the purpose of this study was to evaluate the relationship between symptoms and inflammatory biomarkers measured in the blood of male and female athletes following a sport-related concussion (SRC).ResultsForty athletes (n = 20 male, n = 20 female) from nine interuniversity sport teams at a single institution provided blood samples within one week of an SRC. Twenty inflammatory biomarkers were quantitated by immunoassay. The Sport Concussion Assessment Tool version 5 (SCAT-5) was used to evaluate symptoms. Partial least squares (PLS) analyses were used to evaluate the relationship(s) between biomarkers and symptoms. In males, a positive correlation between interferon (IFN)-γ and symptom severity was observed following SRC. The relationship between IFN-γ and symptoms was significant among all symptom clusters, with cognitive symptoms displaying the largest effect. In females, a significant negative relationship was observed between symptom severity and cytokines IFN-γ, tumor necrosis factor (TNF)-α, and myeloperoxidase (MPO); a positive relationship was observed between symptom severity and MCP-4. Inflammatory mediators were significantly associated with all symptom clusters in females; the somatic symptom cluster displayed the largest effect.ConclusionThese results provide supportive evidence of a divergent relationship between inflammation and symptom burden in male and female athletes following SRC. Future investigations should be cognizant of the potentially sex-specific pathophysiology underlying symptom presentation.
Highlights
Inflammation appears to be an important component of concussion pathophysiology
While there were no significant differences in biomarker concentrations between males and females after correcting for multiple comparisons, uncorrected monocyte chemoattractant protein (MCP)-1 (66.6 vs. 53.3 pg/mL, p = 0.023), macrophage inflammatory protein (MIP)-1B (43.6 vs 31.8 pg/mL, p = 0.007) and Eotaxin (94.2 vs. 81 pg/mL, p = 0.028) concentrations were significantly lower in females compared to males, and IP10 (179.4 vs 207.7 pg/mL, p = 0.026) concentrations were significantly higher in females compared to males
In this study, we identified a significant relationship between symptom burden and systemic inflammation following sport-related concussion (SRC), with differences between males and females
Summary
Inflammation appears to be an important component of concussion pathophysiology. its relationship to symptom burden is unclear. The purpose of this study was to evaluate the relationship between symptoms and inflammatory biomarkers measured in the blood of male and female athletes following a sport-related concussion (SRC). Inflammation presents as a unifying concept, as it has been associated with concussion-like symptoms across numerous medical conditions [5], but is increasingly recognized as an important and prominent feature of concussion secondary injury [6,7,8,9,10]. Investigating the relationship between inflammation and symptom burden following concussion may help elucidate clinically meaningful pathophysiological mechanisms that mediate patient recovery [11, 12]
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