Zonner Steven W, Ejima Keisuke, Bevilacqua Zachary W, Huibregtse Megan E, Charleston Carmen, Fulgar Ciara, Kawata Keisuke
Department of Sports Medicine, Washington Township Medical Foundation, Fremont, CA, United States.
Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, United States.
Front Neurol. 2019 Apr 5;10:327. doi: 10.3389/fneur.2019.00327. eCollection 2019.
Astrocyte-enriched marker, S100B, shows promise for gauging the severity of acute brain trauma, and understanding subconcussive effects will advance its utility in tracking real-time acute brain damage. The aim of the study was to investigate whether serum S100B elevations were associated with frequency and magnitude of subconcussive head impacts in adolescents. This prospective cohort study of 17 high-school football players consisted of the following 12 time points: pre-season baseline, 5 in-season pre-post games, and post-season. A sensor-installed mouthguard recorded the number of head impacts, peak linear (PLA) and peak rotational (PRA) head accelerations from every practice and game. During the 5 games, players wore chest-strap heart-rate monitors to estimate players' excess post-exercise oxygen consumption (EPOC), accounting for physical exertion effects. At each time point, blood samples were obtained and assessed for S100B and creatine kinase levels to account for astrocyte damage/activation and muscle damage, respectively. Using -means clustering on the impact data, players were categorized into high- or low-impact group. Two players withdrew during the first month of the study. A total of 156 blood samples from 15 players were assessed for S100B and creatine kinase levels and included in the analysis. A median value of 596 head impacts from 15 players were recorded during all practices and games in a season. S100B levels were significantly elevated in all post-game measures compared with the respective pre-game values (median-increase, 0.022 μg/L; interquartile-range, 0.011-0.043 μg/L, < 0.05 for all games). Greater acute S100B increases were significantly associated with greater impact frequency, sum of PLA and PRA, with negligible contributions from physical exertion and muscle damage effects. The high-impact group exhibited greater increases in serum S100B levels at post-games than the low-impact group (high vs. low, 0.043 ± 0.035 μg/L vs. 0.019 ± 0.017 μg/L, = 0.002). The degree of acute S100B increases was correlated with subconcussive head impact exposure, suggesting that acute astrocyte damage may be induced in an impact-dependent manner. Acute changes in serum S100B levels may become a useful tool in monitoring real-time brain damage in sports.
富含星形胶质细胞的标志物S100B在评估急性脑外伤严重程度方面显示出前景，而了解次脑震荡效应将提升其在实时追踪急性脑损伤中的效用。本研究的目的是调查青少年血清S100B升高是否与次脑震荡性头部撞击的频率和强度相关。这项对17名高中橄榄球运动员的前瞻性队列研究包括以下12个时间点：季前基线、赛季中5次赛前赛后、以及赛季后。一个安装了传感器的护齿记录了每次训练和比赛中的头部撞击次数、峰值线性（PLA）和峰值旋转（PRA）头部加速度。在5场比赛期间，运动员佩戴胸带式心率监测器以估计运动员运动后过量氧耗（EPOC），从而考虑体力消耗的影响。在每个时间点采集血样并评估S100B和肌酸激酶水平，分别用于评估星形胶质细胞损伤/激活和肌肉损伤情况。利用撞击数据进行均值聚类，将运动员分为高撞击组或低撞击组。两名运动员在研究的第一个月退出。对15名运动员的总共156份血样进行了S100B和肌酸激酶水平评估并纳入分析。在一个赛季的所有训练和比赛中，记录到15名运动员的头部撞击中位数为596次。与各自的赛前值相比，所有赛后测量中的S100B水平均显著升高（中位数增加，0.022μg/L；四分位间距，0.011 - 0.043μg/L，所有比赛P < 0.05）。更大的急性S100B升高与更高的撞击频率、PLA和PRA总和显著相关，而体力消耗和肌肉损伤影响的贡献可忽略不计。高撞击组在赛后血清S100B水平的升高幅度大于低撞击组（高撞击组与低撞击组相比，0.043±0.035μg/L对0.019±0.017μg/L，P = 0.002）。急性S100B升高的程度与次脑震荡性头部撞击暴露相关，表明急性星形胶质细胞损伤可能以撞击依赖的方式诱发。血清S100B水平的急性变化可能成为监测运动中实时脑损伤的有用工具。
