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Neurological Assessment and Its Relationship to CSF Biomarkers in Amateur Boxers

BACKGROUND: Mild traumatic brain injury (TBI) or concussion is common in many sports. Today, neuropsychological evaluation is recommended in the monitoring of a concussion and in return-to-play considerations. To investigate the sensitivity of neuropsychological assessment, we tested amateur boxers...

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Autores principales: Neselius, Sanna, Brisby, Helena, Marcusson, Jan, Zetterberg, Henrik, Blennow, Kaj, Karlsson, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062456/
https://www.ncbi.nlm.nih.gov/pubmed/24941067
http://dx.doi.org/10.1371/journal.pone.0099870
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author Neselius, Sanna
Brisby, Helena
Marcusson, Jan
Zetterberg, Henrik
Blennow, Kaj
Karlsson, Thomas
author_facet Neselius, Sanna
Brisby, Helena
Marcusson, Jan
Zetterberg, Henrik
Blennow, Kaj
Karlsson, Thomas
author_sort Neselius, Sanna
collection PubMed
description BACKGROUND: Mild traumatic brain injury (TBI) or concussion is common in many sports. Today, neuropsychological evaluation is recommended in the monitoring of a concussion and in return-to-play considerations. To investigate the sensitivity of neuropsychological assessment, we tested amateur boxers post bout and compared with controls. Further the relationship between neuropsychological test results and brain injury biomarkers in the cerebrospinal fluid (CSF) were investigated. METHOD: Thirty amateur boxers on high elite level with a minimum of 45 bouts and 25 non-boxing matched controls were included. Memory tests (Rey Osterrieth Complex Figure, Listening Span, Digit Span, Controlled Word Association Test, and computerized testing of episodic memory), tests of processing speed and executive functions (Trail Making, Reaction Time, and Finger Tapping) were performed and related to previously published CSF biomarker results for the axonal injury marker neurofilament light (NFL). RESULTS: The neurological assessment showed no significant differences between boxers and controls, although elevated CSF NFL, as a sign of axonal injury, was detected in about 80% of the boxers 1–6 days post bout. The investigation of the relationship between neuropsychological evaluation and CSF NFL concentrations revealed that boxers with persisting NFL concentration elevation after at least 14 days resting time post bout, had a significantly poorer performance on Trail Making A (p = 0.041) and Simple Reaction Time (p = 0.042) compared to other boxers. CONCLUSION: This is the first study showing traumatic axonal brain injury can be present without measureable cognitive impairment. The repetitive, subconcussive head trauma in amateur boxing causes axonal injury that can be detected with analysis of CSF NFL, but is not sufficient to produce impairment in memory tests, tests of processing speed, or executive functions. The association of prolonged CSF NFL increase in boxers with impairment of processing speed is an interesting observation, which needs to be verified in larger studies.
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spelling pubmed-40624562014-06-24 Neurological Assessment and Its Relationship to CSF Biomarkers in Amateur Boxers Neselius, Sanna Brisby, Helena Marcusson, Jan Zetterberg, Henrik Blennow, Kaj Karlsson, Thomas PLoS One Research Article BACKGROUND: Mild traumatic brain injury (TBI) or concussion is common in many sports. Today, neuropsychological evaluation is recommended in the monitoring of a concussion and in return-to-play considerations. To investigate the sensitivity of neuropsychological assessment, we tested amateur boxers post bout and compared with controls. Further the relationship between neuropsychological test results and brain injury biomarkers in the cerebrospinal fluid (CSF) were investigated. METHOD: Thirty amateur boxers on high elite level with a minimum of 45 bouts and 25 non-boxing matched controls were included. Memory tests (Rey Osterrieth Complex Figure, Listening Span, Digit Span, Controlled Word Association Test, and computerized testing of episodic memory), tests of processing speed and executive functions (Trail Making, Reaction Time, and Finger Tapping) were performed and related to previously published CSF biomarker results for the axonal injury marker neurofilament light (NFL). RESULTS: The neurological assessment showed no significant differences between boxers and controls, although elevated CSF NFL, as a sign of axonal injury, was detected in about 80% of the boxers 1–6 days post bout. The investigation of the relationship between neuropsychological evaluation and CSF NFL concentrations revealed that boxers with persisting NFL concentration elevation after at least 14 days resting time post bout, had a significantly poorer performance on Trail Making A (p = 0.041) and Simple Reaction Time (p = 0.042) compared to other boxers. CONCLUSION: This is the first study showing traumatic axonal brain injury can be present without measureable cognitive impairment. The repetitive, subconcussive head trauma in amateur boxing causes axonal injury that can be detected with analysis of CSF NFL, but is not sufficient to produce impairment in memory tests, tests of processing speed, or executive functions. The association of prolonged CSF NFL increase in boxers with impairment of processing speed is an interesting observation, which needs to be verified in larger studies. Public Library of Science 2014-06-18 /pmc/articles/PMC4062456/ /pubmed/24941067 http://dx.doi.org/10.1371/journal.pone.0099870 Text en © 2014 Neselius et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Neselius, Sanna
Brisby, Helena
Marcusson, Jan
Zetterberg, Henrik
Blennow, Kaj
Karlsson, Thomas
Neurological Assessment and Its Relationship to CSF Biomarkers in Amateur Boxers
title Neurological Assessment and Its Relationship to CSF Biomarkers in Amateur Boxers
title_full Neurological Assessment and Its Relationship to CSF Biomarkers in Amateur Boxers
title_fullStr Neurological Assessment and Its Relationship to CSF Biomarkers in Amateur Boxers
title_full_unstemmed Neurological Assessment and Its Relationship to CSF Biomarkers in Amateur Boxers
title_short Neurological Assessment and Its Relationship to CSF Biomarkers in Amateur Boxers
title_sort neurological assessment and its relationship to csf biomarkers in amateur boxers
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062456/
https://www.ncbi.nlm.nih.gov/pubmed/24941067
http://dx.doi.org/10.1371/journal.pone.0099870
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