Introduction: The neurologic consequences of concussions in sports are well established. Accurate diagnoses of concussions are challenging and studies have looked at biomarkers to provide an objective measure in the diagnosis of concussion. We have designed and implemented a study of collegiate football players with the aim of exploring both novel and known biomarkers to identify a panel to accurately evaluate concussed athletes. This study also correlates biomarkers with concussive events, cognitive testing, and helmet accelerometer data.
Methods: We sampled 56 Louisiana State University football players. Players were matched to non-concussed controls and provided blood samples following any on-field concussion. Physical exams and questionnaires were used to collect data on immediate changes related to injury. Helmet accelerometer data was retrospectively assessed and correlated with clinical and laboratory data. Blood samples were tested for concentrations of arachidonic acid and docosahexaenoic acid derivatives, as well as known concussion biomarkers such as S100B, t-tau, apolipoprotein A1 and others.
Results: There were twelve total concussions suffered by players throughout the preseason & regular season. Of the concussed players, seven had previously sustained a concussion. Only one player still reported having post-concussive symptoms on his final questionnaire. Initial analysis of blood samples reveals a large variance in the biomarkers and large increases in all players with regards to a number of markers (tau, neuroprotectin D1) immediately post-game. Further statistical analysis of the biomarkers, as well as the helmet accelerometer data is ongoing.
Conclusions: The design of this study gives a reproducible protocol for collecting samples from the collegiate athletic field to be studied in the laboratory and correlated with physical exam, cognitive testing, and impact data. We expect the present study will establish a multidisciplinary approach for the collection of a wide array of clinical and laboratory data, further increasing the accuracy with which concussions are diagnosed.
Patient Care: It provides a repeatable protocol for obtaining data related to concussion diagnosis, furthering the research into accurate diagnosis and treatment.
Learning Objectives: Readers should be able to 1) discuss the importance of accurate concussion diagnosis and 2) implement a multidisciplinary protocol for concussion diagnosis.