Shahim Pashtun, Zetterberg Henrik, Tegner Yelverton, Blennow Kaj
From the Institute of Neuroscience and Physiology (P.S., H.Z., K.B.), Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (P.S., H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), UCL Institute of Neurology, Queen Square, London, UK; and the Division of Medical Sciences (Y.T.), Department of Health Sciences, Luleå University of Technology, Sweden.
Neurology. 2017 May 9;88(19):1788-1794. doi: 10.1212/WNL.0000000000003912. Epub 2017 Apr 12.
To evaluate whether the axonal protein neurofilament light (NFL) in serum is a sensitive biomarker to detect subtle brain injury or concussion in contact sports athletes.
Two prospective cohort studies involving (1) 14 Swedish amateur boxers who underwent fluid biomarker assessments at 7-10 days after bout and after 3 months of rest from boxing and (2) 35 Swedish professional hockey players who underwent blood biomarker assessment at 1, 12, 36, and 144 hours after concussion and when the players returned to play were performed. Fourteen healthy nonathletic controls and 12 athletic controls were also enrolled. Serum NFL was measured using ultrasensitive single molecule array technology.
Serum NFL concentrations were increased in boxers 7-10 days after bout as compared to the levels after 3 months rest as well as compared with controls ( = 0.0007 and < 0.0001, respectively). NFL decreased following 3 months of rest, but was still higher than in controls ( < 0.0001). Boxers who received many (>15) hits to the head or were groggy after bout had higher concentrations of serum NFL as compared to those who received fewer hits to the head ( = 0.0023). Serum NFL increased over time in hockey players, and the levels returned to normal at return to play. Importantly, serum NFL could separate players with rapidly resolving postconcussion symptoms (PCS) from those with prolonged PCS.
The results from these 2 independent cohort studies suggest that serum NFL is a highly sensitive biomarker for concussion.
评估血清中的轴突蛋白神经丝轻链（NFL）是否为检测接触性运动运动员细微脑损伤或脑震荡的敏感生物标志物。
进行了两项前瞻性队列研究，其中一项涉及14名瑞典业余拳击手，他们在比赛后7至10天以及停止拳击休息3个月后接受了体液生物标志物评估；另一项涉及35名瑞典职业曲棍球运动员，他们在脑震荡后1、12、36和144小时以及恢复比赛时接受了血液生物标志物评估。还招募了14名健康的非运动员对照和12名运动员对照。使用超灵敏单分子阵列技术测量血清NFL。
与休息3个月后的水平以及与对照组相比，拳击手在比赛后7至10天的血清NFL浓度升高（分别为P = 0.0007和P < 0.0001）。休息3个月后NFL下降，但仍高于对照组（P < 0.0001）。与头部受击较少的拳击手相比，头部受击较多（>15次）或比赛后头晕的拳击手血清NFL浓度更高（P = 0.0023）。曲棍球运动员的血清NFL随时间增加，恢复比赛时水平恢复正常。重要的是，血清NFL可以将脑震荡后症状（PCS）迅速缓解的运动员与PCS持续时间较长的运动员区分开来。
这两项独立队列研究的结果表明，血清NFL是脑震荡的高度敏感生物标志物。
