Bailey Christopher, Soden Daniel, Maroon Joseph, Selman Warren, Tangen Christopher, Gunstad John, Briskin Susannah, Miskovsky Shana, Miller Emiko, Pieper Andrew A
Department of Neurology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
University Hospitals Sports Medicine Concussion Center, University Hospital Cleveland Medical Center, Cleveland, Ohio, USA.
Neurotrauma Rep. 2024 Jun 6;5(1):552-562. doi: 10.1089/neur.2023.0132. eCollection 2024.
To address the need for objective tests of concussion in athletes, we conducted a prospective clinical study in National Collegiate Athletic Association athletes of the relationship between neurocognitive performance and blood levels of the GluA1 subunit of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor peptides and autoantibodies to GluA1. Specifically, we compared 44 contact sport athletes to 16 noncontact sport athletes, with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), as well as blood sample collection, before the start of the season and at the end of the season. Contact sport athletes exhibited significantly elevated serum GluA1 autoantibodies at the end of season, compared with preseason levels, irrespective of whether they sustained a concussion. Noncontact sport athletes showed no change in serum GluA1 autoantibodies, and neither group showed differences in GluA1 peptides. Amongst contact-sport athletes, the 'high GluA1 autoantibody group' (≥4 ng/mL) displayed impaired reaction time, a measure of cognitive impairment, while the 'low GluA1 autoantibody group' (<4 ng/mL) displayed normal reaction time. Our results reveal that contact sport athletes are at risk for developing cognitive impairment even without sustaining a diagnosed concussion and that serum GluA1 autoantibodies provide a blood-based biomarker of this risk. This could guide future studies on the differing susceptibility to cognitive impairment in contact sport athletes and facilitate efficient allocation of resources to contact sport athletes identified as having increased risk of developing cognitive impairment.
为满足对运动员脑震荡进行客观测试的需求，我们对美国国家大学体育协会的运动员进行了一项前瞻性临床研究，以探讨神经认知表现与α-氨基-3-羟基-5-甲基-4-异恶唑丙酸受体肽的GluA1亚基及抗GluA1自身抗体的血液水平之间的关系。具体而言，我们将44名从事接触性运动的运动员与16名从事非接触性运动的运动员进行比较，在赛季开始前和赛季结束时，使用即时 concussion 评估和认知测试（ImPACT），并采集血样。与赛季前水平相比，从事接触性运动的运动员在赛季结束时血清GluA1自身抗体显著升高，无论他们是否遭受脑震荡。从事非接触性运动的运动员血清GluA1自身抗体没有变化，两组在GluA1肽方面均无差异。在从事接触性运动的运动员中，“高GluA1自身抗体组”（≥4 ng/mL）表现出反应时间受损，这是认知障碍的一项指标，而“低GluA1自身抗体组”（<4 ng/mL）表现出正常反应时间。我们的研究结果表明，即使没有被诊断为脑震荡，从事接触性运动的运动员也有发生认知障碍的风险，并且血清GluA1自身抗体提供了这种风险的血液生物标志物。这可以指导未来关于接触性运动运动员对认知障碍不同易感性的研究，并有助于有效地将资源分配给被确定有增加认知障碍风险的接触性运动运动员。
