神经丝轻链和 tau 作为与运动相关脑震荡的血液生物标志物。
Neurofilament light and tau as blood biomarkers for sports-related concussion.
机构信息
From the Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry (P.S., K.B., H.Z.), the Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (P.S., K.B., H.Z.), Sahlgrenska University Hospital, Mölndal; Division of Medical Sciences, Department of Health Sciences (P.S.), Luleå University of Technology; Department of Clinical Sciences (Y.T.), Skåne University Hospital, Lund University, Sweden; Department of Neurology (N.M.), Washington University School of Medicine, St. Louis, MO; Department of Molecular Neuroscience (H.Z.), UCL Institute of Neurology, Queen Square; and UK Dementia Research Institute (H.Z.), London.
出版信息
Neurology. 2018 May 15;90(20):e1780-e1788. doi: 10.1212/WNL.0000000000005518. Epub 2018 Apr 13.
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.
目的
比较神经丝轻链（NfL）和 tau 作为急性运动相关脑震荡（SRC）的基于血液的生物标志物，并确定它们在损伤后不同时间点的浓度是否与延长重返赛场时间（RTP）相关。
方法
2012 年 9 月 1 日至 2015 年 4 月 30 日，对 288 名职业曲棍球运动员进行了纵向随访。2015 年至 2017 年进行了数据收集和生物标志物分析。测试了 NfL 和 tau 与 RTP 时间之间的血液浓度的相关性。还测量了血清 S100B 和神经元特异性烯醇化酶（NSE）的浓度进行比较。
结果
在 288 名运动员中，有 105 人发生了 SRC。其中，87 人在 SRC 后 1、12、36 和 144 小时以及 RTP 时间点进行了血液采样。SRC 后 1、12、36 和 144 小时的血清 NfL 浓度与延长 RTP 时间有关，并且可以将 RTP>10 天的运动员与 RTP≤10 天的运动员区分开来（接收者操作特征曲线下面积 [AUROC]0.82）。此外，SRC 后 144 小时的血清 NfL 可区分因持续脑震荡后症状（PCS）而辞职的运动员和重返赛场的运动员（AUROC0.89）。SRC 后 1 小时的血浆 tau 与 RTP 相关，但与 NfL 相比相关性较弱，而 S100B 和 NSE 则没有这种相关性。
结论
血清 NfL 优于 tau、S100B 和 NSE 作为 SRC 的生物标志物。从临床角度来看，血清 NfL 可能有助于识别有延长 PCS 风险的个体，并有助于基于生物标志物的决策，即何时应考虑 RTP。
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