Acute plasma tau relates to prolonged return to play after concussion
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Abstract
Objective: To determine whether tau changes after sport-related concussion (SRC) relate to return to play (RTP).
Methods: Collegiate athletes underwent preseason plasma sampling and cognitive testing and were followed. After a SRC (n = 46), athletes and controls (n = 37) had sampling at 6 hours, and at 24 hours, 72 hours, and 7 days after SRC. A sample of 21 nonathlete controls were compared at baseline. SRC athletes were grouped by long (>10 days, n = 23) and short (≤10 days, n = 18) RTP. Total tau was measured using an ultrasensitive immunoassay.
Results: Both SRC and athlete controls had significantly higher mean tau at baseline compared to nonathlete healthy controls (F101,3 = 19.644, p < 0.01). Compared to SRC athletes with short RTP, those with long RTP had higher tau concentrations overall, after controlling for sex (F39,1 = 3.59, p = 0.022), compared to long RTP athletes, at 6 (p < 0.01), 24 (p < 0.01), and 72 hours (p = 0.02). Receiver operator characteristic analyses showed that higher plasma tau 6 hours post-SRC was a significant predictor of RTP >10 days (area under the curve 0.81; 95% confidence interval 0.62–0.97, p = 0.01).
Conclusions: Elevated plasma tau concentration within 6 hours following a SRC was related to having a prolonged RTP, suggesting that tau levels may help inform RTP.
GLOSSARY
- ANOVA=
- analysis of variance;
- AUC=
- area under the curve;
- BESS=
- Balance Error Scoring System;
- CI=
- confidence interval;
- CTE=
- chronic traumatic encephalopathy;
- ImPACT=
- Immediate Postconcussion Assessment and Cognitive Testing;
- mTBI=
- mild traumatic brain injury;
- NCAA=
- National Collegiate Athletic Association;
- RTP=
- return to play;
- SRC=
- sports-related concussions;
- TBI=
- traumatic brain injury
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was paid by the authors.
Editorial, page 512
- Received May 20, 2016.
- Accepted in final form October 10, 2016.
- Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Letters: Rapid online correspondence
- Biofluid biomarkers of concussion: One size does not fit all
- Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Centersethinitinmd@hotmail.com
Submitted February 14, 2017
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