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Blood Biomarkers of Sports-Related Concussion in Pediatric Athletes

Anzalone, Anthony J. MS*,†,‡; Turner, Stephanie M. MS*,†,‡; Baleztena, Angela C. MS, ATC*,†,‡; McGuffin, Tiffany MS, ATC*,†,‡; Creed, Kalyssa MS, CCRP*,†,‡; Jeromin, Andreas PhD§; Wilson, David PhD§; Hanlon, David PhD§; Garrison, J. Craig PhD, PT, SCS, ATC*,†,‡; Blueitt, Damond MD*,†,‡; Oliver, Jonathan M. PhD*,†,‡

doi: 10.1097/JSM.0000000000000735
Original Research: PDF Only

Objective: To examine changes in blood biomarkers, serum neurofilament light (Nf-L), and plasma tau, as well as the relationship between blood biomarkers and symptom reports, in athletes with a sports-related concussion.

Design: Prospective cohort study.

Setting: Private community-based concussion clinic.

Participants: Athletes aged 13 to 18 years old with a diagnosed sports-related concussion presenting to a concussion clinic within 7 days of injury and noninjured athletes with no history of concussion aged 13 to 23 years old.

Assessment and Main Outcome Measures: Injured athletes provided a blood sample at the initial clinical evaluation and again at least 6 months after injury. Noninjured athletes provided a single blood sample. All participants completed symptom reports during each visit. Statistical comparisons of biomarker concentrations and symptom reports were conducted.

Results: The mean rank for tau was significantly lower for concussed athletes compared with nonconcussed athletes. In contrast, the mean rank of Nf-L was higher for concussed athletes than for nonconcussed athletes, although the difference was nonsignificant. Plasma tau was significantly lower postinjury compared with 6 months after injury, whereas serum Nf-L was significantly higher postinjury. There was a weak but significant inverse relationship observed between tau and the number of symptoms reported, but no relationship was observed between Nf-L and the number of symptoms reported.

Conclusions: These data indicate that in the days following a sports-related concussion, the blood biomarkers tau and Nf-L display contrasting patterns of change but may not be related to self-reported symptom scores.

*Sport Science Center, Texas Christian University, Fort Worth, Texas;

Texas Health Sports Medicine Concussion Center, Fort Worth, Texas;

Texas Health Sports Medicine, Fort Worth, Texas; and

§Quanterix Corp, Lexington, Massachusetts.

Corresponding Author: Jonathan M. Oliver, PhD, Department of Kinesiology, Sports Concussion Research Group, Texas Christian University, TCU Box 297730, Fort Worth, TX 76129 (

A. Jeromin is a paid advisor to Quanterix Corp and holds stock options. D. Hanlon and D. Wilson are both employees of Quanterix Corp. The remaining authors report no conflicts of interest.

Received April 11, 2018

Accepted November 10, 2018

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