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Knoebel Institute for Healthy Aging

Knoebel Institute


Concussion Study


Concussion or mild traumatic brain injury (mTBI) is one of several leading causes of disability in young adults (Delouche et al., 2016). Many individuals with mTBI or post-concussion disorder have reported physical, balance, emotional and/or cognitive symptoms, which has recently been described as post-concussion syndrome (Meier et al., 2015), which may persist for months or years following the primary injury. Participation in contact sports may expose athletes to repeated head injuries and has therefore been associated with negative mental health outcomes later in life, including depression, aggression and destructive behavior (see e.g. Orr et al., 2015). Although previous studies have included athletes involved in American football (Solomon and Kuhn, 2014; Strain et al., 2015) or ice hockey (Orr et al., 2015), few studies have focused on other contact or high velocity sports, including skiing, soccer or Lacrosse. In addition, although imaging and neurocognitive studies have been conducted, few have examined blood biomarkers for neurotrauma in athletes with or without repeated mild head injuries. The impact of repeated head injuries on continued quality of life and life span is likely underestimated given that many athletes who sustain mTBI but do not seek medical care, or may not receive the appropriate care (e.g. Kasamatsu et al., 2016).

Several recent reports indicate that certain contact sports, such as hockey or American Football may be associated with elevations in specific biomarkers for head trauma, and further suggest that these biomarkers increase during a season of intensive training and play (Oliver et al., 2015). Serum levels of the pro-inflammatory glial marker S100b have been shown to increase following a concussion in athletes (Kiechle et al., 2014), and these investigators found that S100b increased already 3 hours following a concussion-related sports injury. Another marker that has been examined in serum of American football players is neurofilament light polypeptide (NLP; Oliver et al., 2015), which was also found to increase during a season of American football, and has been widely recognized as a good marker for TBI. And recent research suggests that serum elevations of glial fibrillary acidic protein (GFAP) correctly distinguishes concussion patients from uninjured control subjects within one week of injury (Papa et al., 2016). Due to the relative paucity of data available regarding concussion or sub-concussion injuries and their role for blood biomarkers for brain health, we propose to enlist subjects from three groups: 1) Athletes in a high-velocity sport immediately following concussion, 2) Athletes in high-velocity sports without concussion, and 3) Non-athletes without concussion, to explore whether a panel of blood biomarkers can be used to assess the impact of mild TBI on brain health, and also to compare differences in biomarkers between these groups, and associate with score from typical neurocognitive and balance assessments administered in current concussion treatment protocols. The major objective of this study is to obtain pilot data on athlete-related concussions in the Denver area in general, and in DU athletics in particular. The data and blood samples will be kept at the Knoebel Institute for Healthy Aging (KIHA) Biobank at DU and will be de-identified and anonymity strictly maintained at all times.