If you have ever been involved in athletics before, you have probably heard about the risks that being an athlete poses. More specifically, you have heard about concussions and concussion protocol. For athletes, especially at the collegiate level, concussions have not always been taken seriously up until recently. Concussions have a risk of being career-ending, and life-threatening. Now, concussion protocol is more in effect than ever, and something that an athlete will hear about often, however, the protocol still has its flaws. Athletes face a significant risk for concussions, which take up a good amount of Mild Traumatic Brain Injury cases, or mild TBIs. 90% of these mild TBIs go unreported, and people continue their activities not knowing that their brain could be in danger. Dr. Foecking’s research talk about the potential usage of testosterone to help improve the vestibular function and coordination of individuals was extremely insightful, and a question was sparked. What other research was there regarding the concussion protocol, more specifically for athletes? After researching, I came upon Dr. Michael McCrea and his lab’s research. They researched some of the potential biomarkers for concussed athletes, which has the potential to more accurately analyze concussion protocol. The question that he was asking was if a sport’s related concussion in collegiate athletics was associated with these known biomarkers for TBI, and his findings were quite insightful.
Before we get into the findings, we will talk about some of these biomarkers. A biomarker is a known measurable variable that predicts the presence or absence of a disease, injury, or exposure to something. In Dr. McCrea’s lab, biomarkers that were known to predict the presence of a TBI were analyzed in athletes with concussions. Four important biomarkers were analyzed during this experiment. These were: GFAP, which is a glial fibrillary acidic protein, UCH-L1, which stands for ubiquitin C-terminal hydrolase-L1, tau, which is a protein that interacts with neurons in the brain by helping them maintain structure, and NF-L, which is a neurofilament light chain. All of these markers are known to predict TBIs, however, it was unknown exactly which, or if any of these markers would be shown during a sports-related concussion.
The lab took 264 athletes who were concussed, 138 non-concussed athletes who played contact sports, and 102 non-concussed athletes who played non-contact sports. Around 1700 athletes were originally analyzed, however, in total, they only took 504 participants. The athletes were about 70% male. The athletes that were not concussed were used as the two control groups and matched with a concussed athlete based on factors such as the institution they attended, the position and sport they played sex, race, and ethnicity. All of the groups took initial concussion tests as mandated by the NCAA, and also participated in additional balance and coordination testing. They were also initially blood-tested for levels of the 4 biomarkers.
The general findings of Dr. McCrea’s research were that multiple biomarkers were elevated during the concussion period, and in some cases, they were prevalent even after the symptoms of the concussion stopped. The three important biomarkers that were present were GFAP, tau, and UCH-L1, which were present in higher levels than the non-concussed control groups. This experiment had a lot of success because the finding of these biomarkers can vastly help collegiate athletes with their diagnoses and the earlier findings of concussions. Some limitations with this were experienced, such as the study being limited to concussed collegiate athletes of high-contact sports. Either way, this is an amazing step forward for concussion protocol and improving the well-being of athletes.
McCrea’s research goes hand in hand with the research presentation that Dr. Foecking had at Loyola University Chicago on February 13th, 2024. Her lab was engaged in research about how testosterone and estradiol, two hormones that are imperative for our development as humans, can improve vestibular function after a mild TBI, such as a concussion. The vestibular system deals with balance and postural movements that have been found to worsen after repeated brain trauma. While her research was on repetitive mild TBIs, it can be compared to an athlete facing multiple concussions that eventually end their career. Her lab did research on rats, after inducing repeated mild TBIs in their brains, and then giving the experimental group testosterone treatments. Her lab’s research and the findings she had about testosterone improving vestibular function could, with further development, help potentially extend the lives of high-contact athletes and even potentially help extend their careers. Dr. McCrea’s research can also help the lives of athletes by providing a more detailed and accurate way to analyze the severity of concussions, and potentially lower the number of athletes who continue playing while risking the health of their brains, and in turn their lives.
References:
McCrea M, Broglio SP, McAllister TW, et al. Association of Blood Biomarkers With Acute Sport-Related Concussion in Collegiate Athletes: Findings From the NCAA and Department of Defense CARE Consortium. JAMA Netw Open. 2020;3(1):e1919771. doi:10.1001/jamanetworkopen.2019.19771
Eileen M. Foecking, Arthur B. Segismundo, Krista M. Lotesto, Edward J. Westfall, Alyssa J. Bolduan, Tony K. Peter, Douglas G. Wallace, Dorothy A. Kozlowski, Evan B. Stubbs, Sam J. Marzo, Susanna C. Byram. Testosterone treatment restores vestibular function by enhancing neuronal survival in an experimental closed-head repetitive mild traumatic brain injury model, Behavioural Brain Research, Volume 433, 2022, 113998, ISSN 0166-4328
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