Background

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.

Aim

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.

Methods

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.

Results

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).

Conclusion

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.

中文翻译：

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澳大利亚男性业余足球运动员器化护齿器测量的头部加速事件与星形胶质细胞和轴突损伤赛后生物标志物之间的关联

 背景

仪器化护齿器 （iMG） 的进步允许准确量化碰撞运动中单次高加速度头部撞击和累积头部加速度暴露。然而，这些措施与脑细胞损伤风险之间的关系仍不清楚。

 目的

本研究的目的是量化非脑震荡头部撞击暴露的测量，并评估它们与澳大利亚男性足球运动员血液神经胶质纤维酸性蛋白 （GFAP） 、神经丝光 （NfL） 和磷酸化 tau-181 （p-tau-181） 水平的相关性。

 方法

共有 31 名运动员在赛季内 （赛后 24 小时） 和赛季后 （> 5 周） 进行了采血和/或佩戴 HITIQ Nexus A9 iMGs，测量峰值线性 （PLA） 和旋转 （PRA） 加速度。比赛镜头用于验证和编码影响。使用 Simoa 定量血液 GFAP 、 NfL 和 p-tau-181 并转化自然对数进行分析。使用线性混合模型评估赛后生物标志物与匹配内最大单次影响和累积 PLA/PRA 之间的关联。

 结果

发现 GFAP （平均差 0.14,95% CI 0.01-0.26，p = 0.033）、NfL （平均差 = 0.21,95% CI 0.09-0.32，p = 0.001） 和 p-tau-181 （平均差 = 0.49,95% CI 0.33-0.65，p < 0.001）。 赛后 GFAP 与单次匹配中的最大单次影响 PLA （B = 0.003,95% CI 0.0002–0.005，p = 0.036）、累积 PLA （B = 0.001,95% CI 0.0002–0.002，p = 0.017）、累积 PRA （B = 0.01,95% CI 0.002–0.02，p = 0.014） 和影响数 （B = 0.03,95% CI 0.003–0.05，p = 0.029） 相关。 两次匹配之间 NfL 水平的变化与累积 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） 和影响数 （r = 0.63,95% CI 0.05-0.89，p = 0.038） 相关。

 结论

通过 iMG 测量的澳大利亚足球最大和累积头部加速度与脑损伤的血液生物标志物升高有关，突出了这两种技术在碰撞运动中头部碰撞管理的潜力。