Serum markers of football-related brain concussions: a pilot study

描述（由申请人提供）：脑震荡是运动中脑损伤的主要原因，特别是在美式足球中。对足球运动员脑震荡频率的估计表明，高达40%的参与者每年都会经历脑震荡，其中大多数都没有报告。今天，脑震荡是根据行为相关性（脑震荡后立即评估，ImPACT和认知测试）确认或排除的，而无需标准化实验室测试的帮助。因此，脑震荡的诊断仍然具有挑战性和主观性。此外，详细的神经系统测试可能会在事件发生后延迟数天，从而产生不确定性和潜在风险。 脑震荡或创伤性脑损伤（TBI）通常与脑血管（血脑屏障，BBB）完整性的快速丧失相关，随后发生脑损伤。因此，检测早期血脑屏障变化对预测脑震荡后脑损伤的发展具有重要意义。S100 B已成为BBB通透性的候选外周生物标志物。S100 B血清水平的升高反映了BBB受损的存在，并可能预测脑损伤。我们获得了测量血清S100B在一个队列的大学队球员的初步结果。S100B水平在比赛前、比赛后立即和比赛后一天进行测量。在那些位置预测头对头碰撞可能性最高的球员中，比赛结束后立即出现的平均S100B水平明显高于基线。R21的主要目标是验证在足球中使用隐性脑震荡的替代血清标志物。我们将比较血清标志物与公认的脑震荡测试方法（例如，SCAT2）和成像数据（DTI）在选定的球员。 血液测试可能具有诊断价值，影响治疗医生对重返赛场的建议，并提供潜在的长期病理性大脑变化的指示。

DESCRIPTION (provided by applicant): Concussions are the leading cause of brain damage in sports, particularly in American football. Estimates of the frequency of concussions among football players suggest that up to 40% of participants experience a concussion on an annual basis, the majority of these going unreported. Today, concussions are confirmed or ruled out based on behavioral correlates (Immediate Post-Concussion Assessment, ImPACT and Cognitive Testing) and without the aid of standardized laboratory testing. As a result, the diagnosis of concussion remains challenging and subjective. In addition, detailed neurological testing may be delayed for several days after the event, creating uncertainty and potential risk. Concussions, or traumatic brain injury (TBI) in general, are associated with a rapid loss of cerebrovascular (blood-brain barrier, BBB) integrity followed by the development of brain damage. It is therefore significant to detect early BBB changes to predict development of post-concussion brain damage. S100B has emerged as a candidate peripheral biomarker of BBB permeability. Elevation of S100B serum levels reflect the presence of a damaged BBB and may predict brain injury. We obtained preliminary results measuring serum S100B in a cohort of college team players. S100B levels were measured prior to, immediately after and one day post-game. Average S100B levels immediately after the game were significantly higher than baseline in those players whose position predicts highest likelihood of head-to- head impact. The main goal of this R21 is to validate the use of surrogate serum markers of occult concussion in football. We will compare serum marker to accepted means of concussion testing (e.g., SCAT2) and to imaging data (DTI) obtained in selected players. A blood test could have a diagnostic value influencing the treating physician's recommendation for return to play and providing indication of potential long-term pathological brain changes.