Astroglial activation and altered amyloid metabolism in human repetitive concussion
(2017) In Neurology 88(15). p.1400-1407- Abstract
OBJECTIVE: To determine whether postconcussion syndrome (PCS) due to repetitive concussive traumatic brain injury (rcTBI) is associated with CSF biomarker evidence of astroglial activation, amyloid deposition, and blood-brain barrier (BBB) impairment.
METHODS: A total of 47 participants (28 professional athletes with PCS and 19 controls) were assessed with lumbar puncture (median 1.5 years, range 0.25-12 years after last concussion), standard MRI of the brain, and Rivermead Post-Concussion Symptoms Questionnaire (RPQ). The main outcome measures were CSF concentrations of astroglial activation markers (glial fibrillary acidic protein [GFAP] and YKL-40), markers reflecting amyloid precursor protein metabolism (Aβ38, Aβ40, Aβ42,... (More)
OBJECTIVE: To determine whether postconcussion syndrome (PCS) due to repetitive concussive traumatic brain injury (rcTBI) is associated with CSF biomarker evidence of astroglial activation, amyloid deposition, and blood-brain barrier (BBB) impairment.
METHODS: A total of 47 participants (28 professional athletes with PCS and 19 controls) were assessed with lumbar puncture (median 1.5 years, range 0.25-12 years after last concussion), standard MRI of the brain, and Rivermead Post-Concussion Symptoms Questionnaire (RPQ). The main outcome measures were CSF concentrations of astroglial activation markers (glial fibrillary acidic protein [GFAP] and YKL-40), markers reflecting amyloid precursor protein metabolism (Aβ38, Aβ40, Aβ42, sAPPα, and sAPPβ), and BBB function (CSF:serum albumin ratio).
RESULTS: Nine of the 28 athletes returned to play within a year, while 19 had persistent PCS >1 year. Athletes with PCS >1 year had higher RPQ scores and number of concussions than athletes with PCS <1 year. Median concentrations of GFAP and YKL-40 were higher in athletes with PCS >1 year compared with controls, although with an overlap between the groups. YKL-40 correlated with RPQ score and the lifetime number of concussions. Athletes with rcTBI had lower concentrations of Aβ40 and Aβ42 than controls. The CSF:serum albumin ratio was unaltered.
CONCLUSIONS: This study suggests that PCS may be associated with biomarker evidence of astroglial activation and β-amyloid (Aβ) dysmetabolism in the brain. There was no clear evidence of Aβ deposition as Aβ40 and Aβ42 were reduced in parallel. The CSF:serum albumin ratio was unaltered, suggesting that the BBB is largely intact in PCS.
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- author
- Shahim, Pashtun ; Tegner, Yelverton ; Marklund, Niklas LU ; Höglund, Kina ; Portelius, Erik ; Brody, David L ; Blennow, Kaj LU and Zetterberg, Henrik LU
- publishing date
- 2017
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Journal Article
- in
- Neurology
- volume
- 88
- issue
- 15
- pages
- 1400 - 1407
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- scopus:85018646525
- pmid:28283595
- ISSN
- 1526-632X
- DOI
- 10.1212/WNL.0000000000003816
- language
- English
- LU publication?
- no
- id
- b92c13e4-da08-4ca7-8fea-e218ee358753
- date added to LUP
- 2017-04-11 10:46:36
- date last changed
- 2024-08-19 20:11:42
@article{b92c13e4-da08-4ca7-8fea-e218ee358753, abstract = {{<p>OBJECTIVE: To determine whether postconcussion syndrome (PCS) due to repetitive concussive traumatic brain injury (rcTBI) is associated with CSF biomarker evidence of astroglial activation, amyloid deposition, and blood-brain barrier (BBB) impairment.</p><p>METHODS: A total of 47 participants (28 professional athletes with PCS and 19 controls) were assessed with lumbar puncture (median 1.5 years, range 0.25-12 years after last concussion), standard MRI of the brain, and Rivermead Post-Concussion Symptoms Questionnaire (RPQ). The main outcome measures were CSF concentrations of astroglial activation markers (glial fibrillary acidic protein [GFAP] and YKL-40), markers reflecting amyloid precursor protein metabolism (Aβ38, Aβ40, Aβ42, sAPPα, and sAPPβ), and BBB function (CSF:serum albumin ratio).</p><p>RESULTS: Nine of the 28 athletes returned to play within a year, while 19 had persistent PCS >1 year. Athletes with PCS >1 year had higher RPQ scores and number of concussions than athletes with PCS <1 year. Median concentrations of GFAP and YKL-40 were higher in athletes with PCS >1 year compared with controls, although with an overlap between the groups. YKL-40 correlated with RPQ score and the lifetime number of concussions. Athletes with rcTBI had lower concentrations of Aβ40 and Aβ42 than controls. The CSF:serum albumin ratio was unaltered.</p><p>CONCLUSIONS: This study suggests that PCS may be associated with biomarker evidence of astroglial activation and β-amyloid (Aβ) dysmetabolism in the brain. There was no clear evidence of Aβ deposition as Aβ40 and Aβ42 were reduced in parallel. The CSF:serum albumin ratio was unaltered, suggesting that the BBB is largely intact in PCS.</p>}}, author = {{Shahim, Pashtun and Tegner, Yelverton and Marklund, Niklas and Höglund, Kina and Portelius, Erik and Brody, David L and Blennow, Kaj and Zetterberg, Henrik}}, issn = {{1526-632X}}, keywords = {{Journal Article}}, language = {{eng}}, number = {{15}}, pages = {{1400--1407}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{Neurology}}, title = {{Astroglial activation and altered amyloid metabolism in human repetitive concussion}}, url = {{http://dx.doi.org/10.1212/WNL.0000000000003816}}, doi = {{10.1212/WNL.0000000000003816}}, volume = {{88}}, year = {{2017}}, }