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- Shahim, Pashtun, 1984, et al.
(författare)
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Blood biomarkers for brain injury in concussed professional ice hockey players
- 2014
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Ingår i: JAMA Neurology. - : American Medical Association (AMA). - 2168-6149 .- 2168-6157. ; 71:6, s. 684-692
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Lack of objective biomarkers for brain damage hampers acute diagnosis and clinical decision making about return to play after sports-related concussion. OBJECTIVES To determine whether sports-related concussion is associated with elevated levels of blood biochemical markers of injury to the central nervous system and to assess whether plasma levels of these biomarkers predict return to play in professional ice hockey players with sports-related concussion. DESIGN, SETTING, AND PARTICIPANTS Multicenter prospective cohort study involving all 12teams of the top professional ice hockey league in Sweden, the Swedish Hockey League. Two hundred eighty-eight professional ice hockey players from 12 teams contesting during the 2012-2013 season consented to participate. All players underwent clinical preseason baseline testing regarding concussion assessment measures. Forty-seven players from 2 of the 12 ice hockey teams underwent blood sampling prior to the start of the season. Thirty-five players had a concussion from September 13, 2012, to January 31, 2013; of these players, 28 underwent repeated blood sampling at 1, 12, 36, and 144 hours and when the players returned to play. MAIN OUTCOMES AND MEASURES Total tau, S-100 calcium-binding protein B, and neuron-specific enolase concentrations in plasma and serum were measured.
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- Shahim, Pashtun, 1984, et al.
(författare)
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Serum visinin-like protein-1 in concussed professional ice hockey players
- 2015
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Ingår i: Brain Injury. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 29:7-8, s. 872-876
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Tidskriftsartikel (refereegranskat)abstract
- Primary objective: Visinin-like protein-1 (VILIP-1) has shown potential utility as a biomarker for neuronal injury in cerebrospinal fluid. This study investigated serum VILIP-1 as a diagnostic and prognostic marker in sports-related concussion. Methods: This multi-centre prospective cohort study involved the 12 teams of the professional ice hockey league in Sweden. A total of 288 players consented to participate in the study. Thirty-five players sustained concussions, of whom 28 underwent repeated blood samplings at 1, 12, 36 and 144 hours after the trauma or when the player returned to play (7-90+ days). Main outcomes and results: The highest levels of VILIP-1 were measured 1 hour after concussion and the levels decreased during rehabilitation, reaching a minimum level at the 36-hour sampling. However, the levels of serum VILIP-1 at 1 hour after concussion were not significantly higher than pre-season baseline values. Serum levels of VILIP-1 1 hour post-concussion did not correlate with-the number of days for the concussion symptoms to resolve. Further, serum levels of VILIP-1 increased after a friendly game in players who were not concussed. Conclusions: These results provide evidence that serum VILIP-1 may not be a useful biomarker for diagnosis and prognosis of sports-related concussion.
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- Siman, Robert, et al.
(författare)
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Serum SNTF Increases in Concussed Professional Ice Hockey Players and Relates to the Severity of Post-Concussion Symptoms
- 2015
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Ingår i: Journal of Neurotrauma. - : Mary Ann Liebert Inc. - 0897-7151 .- 1557-9042. ; 32:17, s. 1294-1300
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Tidskriftsartikel (refereegranskat)abstract
- Biomarkers for diffuse axonal injury could have utilities for the acute diagnosis and clinical care of concussion, including those related to sports. The calpain-derived alpha-spectrin N-terminal fragment SNTF accumulates in axons after traumatic injury, and increases in human blood following mild traumatic brain injury (mTBI) in relation to white matter abnormalities and persistent cognitive dysfunction. However, SNTF has never been evaluated as a biomarker for sports-related concussion. Here, we conducted longitudinal analysis of serum SNTF in professional ice hockey players, 28 of whom had a concussion, along with 45 players evaluated during the preseason, 17 of whom were also tested after a concussion-free training game. Compared to preseason levels, serum SNTF increased at 1 hour after concussion and remained significantly elevated from 12 hours to 6 days, before declining to preseason baseline. In contrast, serum SNTF levels were unchanged after training. In eight players, post-concussion symptoms resolved within a few days, and in these cases serum SNTF levels were at baseline. On the other hand, for the 20 players withheld from play for 6 days or longer, serum SNTF levels rose from 1 hour to 6 days post-concussion, and at 12-36 hours differed significantly from the less severe concussions (p=.004). Serum SNTF exhibited diagnostic accuracy for concussion, especially so with delayed return to play (AUC = 0.87). Multivariate analyses of serum SNTF and tau improved the diagnostic accuracy, the relationship with the delay in return to play, and the temporal window beyond tau alone. These results provide evidence that blood SNTF, a biomarker for axonal injury after mTBI, may be useful for diagnosis and prognosis of sports-related concussion, and for guiding neurobiologically-informed decisions on return to play
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