Neurofilament light and tau as blood biomarkers for sports-related concussion

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Neurofilament light and tau as blood biomarkers for sports-related concussion. / Shahim, Pashtun; Tegner, Yelverton; Marklund, Niklas; Blennow, Kaj; Zetterberg, Henrik.

In: Neurology, Vol. 90, No. 20, 15.05.2018, p. e1780-e1788.

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Shahim, Pashtun ; Tegner, Yelverton ; Marklund, Niklas ; Blennow, Kaj ; Zetterberg, Henrik. / Neurofilament light and tau as blood biomarkers for sports-related concussion. In: Neurology. 2018 ; Vol. 90, No. 20. pp. e1780-e1788.

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TY - JOUR

T1 - Neurofilament light and tau as blood biomarkers for sports-related concussion

AU - Shahim, Pashtun

AU - Tegner, Yelverton

AU - Marklund, Niklas

AU - Blennow, Kaj

AU - Zetterberg, Henrik

N1 - Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

PY - 2018/5/15

Y1 - 2018/5/15

N2 - OBJECTIVE: To compare neurofilament light (NfL) and tau as blood-based biomarkers for acute sports-related concussion (SRC) and determine whether their concentrations at different time points after the injury are associated with prolonged time to return to play (RTP).METHODS: A total of 288 professional hockey players were followed longitudinally from September 1, 2012, to April 30, 2015. Data collection and biomarker analyses were conducted between 2015 and 2017. Associations were tested between blood concentrations of NfL and tau, and RTP time. Serum concentrations of S100B and neuron-specific enolase (NSE) were also measured for comparison.RESULTS: Of 288 players, 105 sustained an SRC. Of these, 87 underwent blood sampling 1, 12, 36, and 144 hours after SRC and at the RTP time point. Serum NfL concentrations 1, 12, 36, and 144 hours after SRC were related to prolonged RTP time, and could separate players with RTP >10 days from those with RTP ≤10 days (area under the receiver operating characteristic curve [AUROC] 0.82). Also, serum NfL 144 hours after SRC discriminated players who resigned from the game due to persistent postconcussion symptoms (PCS) from those who returned to play (AUROC 0.89). Plasma tau 1 hour after SRC was related to RTP but less strongly than NfL, while S100B and NSE showed no such associations.CONCLUSION: Serum NfL outperformed tau, S100B, and NSE as a biomarker for SRC. From a clinical standpoint, serum NfL may be useful to identify individuals at risk of prolonged PCS, and may aid in biomarker-informed decisions with regard to when RTP should be considered.

AB - OBJECTIVE: To compare neurofilament light (NfL) and tau as blood-based biomarkers for acute sports-related concussion (SRC) and determine whether their concentrations at different time points after the injury are associated with prolonged time to return to play (RTP).METHODS: A total of 288 professional hockey players were followed longitudinally from September 1, 2012, to April 30, 2015. Data collection and biomarker analyses were conducted between 2015 and 2017. Associations were tested between blood concentrations of NfL and tau, and RTP time. Serum concentrations of S100B and neuron-specific enolase (NSE) were also measured for comparison.RESULTS: Of 288 players, 105 sustained an SRC. Of these, 87 underwent blood sampling 1, 12, 36, and 144 hours after SRC and at the RTP time point. Serum NfL concentrations 1, 12, 36, and 144 hours after SRC were related to prolonged RTP time, and could separate players with RTP >10 days from those with RTP ≤10 days (area under the receiver operating characteristic curve [AUROC] 0.82). Also, serum NfL 144 hours after SRC discriminated players who resigned from the game due to persistent postconcussion symptoms (PCS) from those who returned to play (AUROC 0.89). Plasma tau 1 hour after SRC was related to RTP but less strongly than NfL, while S100B and NSE showed no such associations.CONCLUSION: Serum NfL outperformed tau, S100B, and NSE as a biomarker for SRC. From a clinical standpoint, serum NfL may be useful to identify individuals at risk of prolonged PCS, and may aid in biomarker-informed decisions with regard to when RTP should be considered.

U2 - 10.1212/WNL.0000000000005518

DO - 10.1212/WNL.0000000000005518

M3 - Article

VL - 90

SP - e1780-e1788

JO - Neurology

T2 - Neurology

JF - Neurology

SN - 1526-632X

IS - 20

ER -