Lauren J. Evans, William T. O’Brien, Gershon Spitz, Steven Mutimer, Becca Xie, Lauren P. Giesler, Brendan P. Major, James W. Hickey, Spencer S. H. Roberts, Biswadev Mitra, Terence J. O’Brien, Sandy R. Shultz, Stuart J. McDonald
{"title":"用口罩测量的男性业余澳大利亚足球运动员头部加速度事件与赛后星形胶质细胞和轴突损伤生物标志物之间的关系","authors":"Lauren J. Evans, William T. O’Brien, Gershon Spitz, Steven Mutimer, Becca Xie, Lauren P. Giesler, Brendan P. Major, James W. Hickey, Spencer S. H. Roberts, Biswadev Mitra, Terence J. O’Brien, Sandy R. Shultz, Stuart J. McDonald","doi":"10.1007/s40279-024-02138-6","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Advances in instrumented mouthguards (iMGs) allow for accurate quantification of single high-acceleration head impacts and cumulative head acceleration exposure in collision sports. However, relationships between these measures and risk of brain cell injury remain unclear.</p><h3 data-test=\"abstract-sub-heading\">Aim</h3><p>The purpose of this study was to quantify measures of non-concussive head impact exposure and assess their association with blood glial fibrillary acidic protein (GFAP), neurofilament light (NfL) and phosphorylated-tau-181 (p-tau-181) levels in male Australian football players.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A total of 31 athletes underwent in-season (24 h post-match) and post-season (> 5 weeks) blood collections and/or wore HITIQ Nexus A9 iMGs measuring peak linear (PLA) and rotational (PRA) acceleration. Match footage was used to verify and code impacts. Blood GFAP, NfL, and p-tau-181 were quantified using Simoa and natural log transformed for analysis. Associations between post-match biomarkers and within match maximum single impact and cumulative PLA/PRA were assessed with linear mixed models.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In-season versus post-season elevations were found for GFAP (mean difference 0.14, 95% CI 0.01–0.26, <i>p</i> = 0.033), NfL (mean difference = 0.21, 95% CI 0.09–0.32, <i>p</i> = 0.001) and p-tau-181 (mean difference = 0.49, 95% CI 0.33–0.65, <i>p</i> < 0.001). Post-match GFAP was associated with maximum single impact PLA (<i>B</i> = 0.003, 95% CI 0.0002–0.005, <i>p</i> = 0.036), cumulative PLA (<i>B</i> = 0.001, 95% CI 0.0002–0.002, <i>p</i> = 0.017), cumulative PRA (<i>B</i> = 0.01, 95% CI 0.002–0.02, <i>p</i> = 0.014), and impact number (<i>B</i> = 0.03, 95% CI 0.003–0.05, <i>p</i> = 0.029) within a single match. Change in NfL levels between two-matches correlated with cumulative PLA (<i>r</i> = 0.80, 95% CI 0.38–0.95, <i>p</i> = 0.005), PRA (<i>r</i> = 0.71, 95% CI 0.19–0.92, <i>p</i> = 0.019) and impact number (<i>r</i> = 0.63, 95% CI 0.05–0.89, <i>p</i> = 0.038).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Maximum and cumulative head accelerations in Australian football, measured by iMGs, were associated with elevated blood biomarkers of brain injury, highlighting the potential of both technologies for head impact management in collision sports.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":9.3000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations Between Instrumented Mouthguard-Measured Head Acceleration Events and Post-Match Biomarkers of Astroglial and Axonal Injury in Male Amateur Australian Football Players\",\"authors\":\"Lauren J. 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However, relationships between these measures and risk of brain cell injury remain unclear.</p><h3 data-test=\\\"abstract-sub-heading\\\">Aim</h3><p>The purpose of this study was to quantify measures of non-concussive head impact exposure and assess their association with blood glial fibrillary acidic protein (GFAP), neurofilament light (NfL) and phosphorylated-tau-181 (p-tau-181) levels in male Australian football players.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>A total of 31 athletes underwent in-season (24 h post-match) and post-season (> 5 weeks) blood collections and/or wore HITIQ Nexus A9 iMGs measuring peak linear (PLA) and rotational (PRA) acceleration. Match footage was used to verify and code impacts. Blood GFAP, NfL, and p-tau-181 were quantified using Simoa and natural log transformed for analysis. Associations between post-match biomarkers and within match maximum single impact and cumulative PLA/PRA were assessed with linear mixed models.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>In-season versus post-season elevations were found for GFAP (mean difference 0.14, 95% CI 0.01–0.26, <i>p</i> = 0.033), NfL (mean difference = 0.21, 95% CI 0.09–0.32, <i>p</i> = 0.001) and p-tau-181 (mean difference = 0.49, 95% CI 0.33–0.65, <i>p</i> < 0.001). Post-match GFAP was associated with maximum single impact PLA (<i>B</i> = 0.003, 95% CI 0.0002–0.005, <i>p</i> = 0.036), cumulative PLA (<i>B</i> = 0.001, 95% CI 0.0002–0.002, <i>p</i> = 0.017), cumulative PRA (<i>B</i> = 0.01, 95% CI 0.002–0.02, <i>p</i> = 0.014), and impact number (<i>B</i> = 0.03, 95% CI 0.003–0.05, <i>p</i> = 0.029) within a single match. 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引用次数: 0
摘要
背景仪器式护齿（iMGs）的进步使得在碰撞运动中对单次高加速度头部撞击和累积头部加速度暴露进行精确量化成为可能。本研究的目的是量化非撞击性头部撞击暴露的测量值，并评估它们与澳大利亚男子足球运动员血液中神经胶质纤维酸性蛋白（GFAP）、神经丝光（NfL）和磷酸化-tau-181（p-tau-181）水平之间的关系。方法共有 31 名运动员接受了赛季中（赛后 24 小时）和赛季后（5 周）的血液采集和/或佩戴 HITIQ Nexus A9 iMG 测量峰值线性加速度 (PLA) 和旋转加速度 (PRA)。比赛录像用于验证和编码影响。使用 Simoa 对血液 GFAP、NfL 和 p-tau-181 进行量化，并进行自然对数转换以进行分析。使用线性混合模型评估了赛后生物标志物与赛内最大单次冲击力和累积 PLA/PRA 之间的关系。结果发现，赛季内与赛季后的 GFAP（平均差异为 0.14，95% CI 为 0.01-0.26，p = 0.033）、NfL（平均差异为 0.21，95% CI 为 0.09-0.32，p = 0.001）和 p-tau-181（平均差异为 0.49，95% CI 为 0.33-0.65，p <0.001）均有所升高。比赛后 GFAP 与单场比赛中的最大单次冲击 PLA（B = 0.003，95% CI 0.0002-0.005，p = 0.036）、累计 PLA（B = 0.001，95% CI 0.0002-0.002，p = 0.017）、累计 PRA（B = 0.01，95% CI 0.002-0.02，p = 0.014）和冲击次数（B = 0.03，95% CI 0.003-0.05，p = 0.029）相关。两场比赛之间 NfL 水平的变化与累积 PLA（r = 0.80，95% CI 0.38-0.95，p = 0.005）、PRA（r = 0.71，95% CI 0.19-0.92，p = 0.019）和撞击次数（r = 0.63，95% CI 0.05-0.89，p = 0.038）相关。结论通过 iMGs 测量的澳式足球运动中的最大和累积头部加速度与脑损伤血液生物标志物的升高有关，这凸显了这两种技术在碰撞运动中头部撞击管理方面的潜力。
Associations Between Instrumented Mouthguard-Measured Head Acceleration Events and Post-Match Biomarkers of Astroglial and Axonal Injury in Male Amateur Australian Football Players
Background
Advances in instrumented mouthguards (iMGs) allow for accurate quantification of single high-acceleration head impacts and cumulative head acceleration exposure in collision sports. However, relationships between these measures and risk of brain cell injury remain unclear.
Aim
The purpose of this study was to quantify measures of non-concussive head impact exposure and assess their association with blood glial fibrillary acidic protein (GFAP), neurofilament light (NfL) and phosphorylated-tau-181 (p-tau-181) levels in male Australian football players.
Methods
A total of 31 athletes underwent in-season (24 h post-match) and post-season (> 5 weeks) blood collections and/or wore HITIQ Nexus A9 iMGs measuring peak linear (PLA) and rotational (PRA) acceleration. Match footage was used to verify and code impacts. Blood GFAP, NfL, and p-tau-181 were quantified using Simoa and natural log transformed for analysis. Associations between post-match biomarkers and within match maximum single impact and cumulative PLA/PRA were assessed with linear mixed models.
Results
In-season versus post-season elevations were found for GFAP (mean difference 0.14, 95% CI 0.01–0.26, p = 0.033), NfL (mean difference = 0.21, 95% CI 0.09–0.32, p = 0.001) and p-tau-181 (mean difference = 0.49, 95% CI 0.33–0.65, p < 0.001). Post-match GFAP was associated with maximum single impact PLA (B = 0.003, 95% CI 0.0002–0.005, p = 0.036), cumulative PLA (B = 0.001, 95% CI 0.0002–0.002, p = 0.017), cumulative PRA (B = 0.01, 95% CI 0.002–0.02, p = 0.014), and impact number (B = 0.03, 95% CI 0.003–0.05, p = 0.029) within a single match. Change in NfL levels between two-matches correlated with cumulative PLA (r = 0.80, 95% CI 0.38–0.95, p = 0.005), PRA (r = 0.71, 95% CI 0.19–0.92, p = 0.019) and impact number (r = 0.63, 95% CI 0.05–0.89, p = 0.038).
Conclusion
Maximum and cumulative head accelerations in Australian football, measured by iMGs, were associated with elevated blood biomarkers of brain injury, highlighting the potential of both technologies for head impact management in collision sports.
期刊介绍：
Sports Medicine focuses on providing definitive and comprehensive review articles that interpret and evaluate current literature, aiming to offer insights into research findings in the sports medicine and exercise field. The journal covers major topics such as sports medicine and sports science, medical syndromes associated with sport and exercise, clinical medicine's role in injury prevention and treatment, exercise for rehabilitation and health, and the application of physiological and biomechanical principles to specific sports.
Types of Articles:
Review Articles: Definitive and comprehensive reviews that interpret and evaluate current literature to provide rationale for and application of research findings.
Leading/Current Opinion Articles: Overviews of contentious or emerging issues in the field.
Original Research Articles: High-quality research articles.
Enhanced Features: Additional features like slide sets, videos, and animations aimed at increasing the visibility, readership, and educational value of the journal's content.
Plain Language Summaries: Summaries accompanying articles to assist readers in understanding important medical advances.
Peer Review Process:
All manuscripts undergo peer review by international experts to ensure quality and rigor. The journal also welcomes Letters to the Editor, which will be considered for publication.
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