Evans Lauren J, O'Brien William T, Spitz Gershon, Mutimer Steven, Xie Becca, Giesler Lauren P, Major Brendan P, Hickey James W, Roberts Spencer S H, Mitra Biswadev, O'Brien Terence J, Shultz Sandy R, McDonald Stuart J
Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC, Australia.
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
Sports Med. 2025 Apr;55(4):1037-1049. doi: 10.1007/s40279-024-02138-6. Epub 2024 Nov 19.
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.
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.
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.
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).
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.
仪器化护齿器（iMGs）的进展使得在碰撞运动中能够准确量化单次高加速度头部撞击以及累积头部加速度暴露情况。然而，这些测量指标与脑细胞损伤风险之间的关系仍不明确。
本研究的目的是量化非脑震荡性头部撞击暴露的测量指标，并评估其与澳大利亚男性足球运动员血液中胶质纤维酸性蛋白（GFAP）、神经丝轻链（NfL）和磷酸化tau-181（p-tau-181）水平之间的关联。
共有31名运动员在赛季中（赛后24小时）和赛季后（超过5周）进行了血液采集，和/或佩戴了HITIQ Nexus A9 iMGs，以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撞击情况。使用单分子阵列技术（Simoa）对血液中的GFAP、NfL和p-tau-181进行定量，并进行自然对数转换以进行分析。使用线性混合模型评估赛后生物标志物与比赛中最大单次撞击以及累积PLA/PRA之间的关联。
发现赛季中与赛季后相比，GFAP（平均差异0.14，95%置信区间0.01 - 0.26，p = 0.033）、NfL（平均差异 = 0.21，95%置信区间0.09 - 0.32，p = 0.001）和p-tau-181（平均差异 = 0.49，95%置信区间0.33 - 0.65，p < 0.001）有所升高。赛后GFAP与单次比赛中的最大单次撞击PLA（B = 0.003，95%置信区间0.0002 - 0.005，p = 0.036）、累积PLA（B = 0.001，95%置信区间0.0002 - 0.002，p = 0.017）、累积PRA（B = 0.01，95%置信区间0.002 - 0.02，p = 0.014）以及撞击次数（B = 0.03，95%置信区间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%置信区间0.38 - 0.95，p = 0.005）、PRA（r = 0.71，95%置信区间0.19 - 0.92，p = 0.019）和撞击次数（r = 0.63，95%置信区间0.05 - 0.89，p = 0.038）相关。
通过iMGs测量的澳大利亚足球比赛中的最大和累积头部加速度与脑损伤血液生物标志物升高相关，突出了这两种技术在碰撞运动中头部撞击管理方面的潜力。
