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Second Round Abstract Submissions
9) Residual/Long Term Effects
9.6 Optimizing concussion care seeking (OCCS): connecting care-seeking behaviors and neurophysiological states through blood biomarkers
  1. Christopher D’Lauro1,
  2. Johna Register-Mihailik2,
  3. Timothy Meier3,
  4. Zachary Kerr2,
  5. Steven P Broglio5,
  6. Robert C Lynall6,
  7. Julia Dawn Drattell6,
  8. Daniel Leeds7,
  9. Emily Kroshus8,
  10. Michael McCrea3,
  11. Thomas W McAllister9,
  12. Julianne D Schmidt6
  1. 1Department of Behavioral Science and Leadership, USA Air Force Academy, Colorado Springs, CO, USA
  2. 2Matthew Gfeller Center and STAR Heel Performance Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill,, Chapel Hill, NC, USA
  3. 3Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
  4. 5University of Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
  5. 6UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
  6. 7Computer and Information Sciences, Fordham University, New York, NY, USA
  7. 8University of Washington, Department of Pediatrics and Seattle Children’s Research Institute, Center for Child, Development and Health, Seattle, WA, USA
  8. 9Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA

Abstract

Objective More than half of concussions go unreported or are reported with delay, yet the neurobiological impact of this remains unknown. We aimed to compare post-concussion biomarkers among individuals with different concussion histories and reporting status.

Design Longitudinal cohort.

Setting Clinical.

Participants Blood samples were collected from 287 military academy cadets and collegiate athletes diagnosed with concussion in the Advanced Research arm of the Concussion Assessment, Research, and Education (CARE) Consortium.

Interventions (or Assessment of Risk Factors) We extracted each participant’s self-reported a) previous concussion diagnosis status (no history, all diagnosed, 1+ undiagnosed) and b) whether they had delayed or immediate symptom onset, symptom reporting, and/or removal from activity following the incident concussion.

Outcome Measures We compared the following neural injury blood biomarkers between previous concussion diagnosis status groups and care-seeking groups: glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase-L1 (UCH-L1), neurofilament light chain (NF-L), and tau protein – captured at baseline, 24–48 hours, asymptomatic, and 7 days post-unrestricted return-to-activity using tests of parallel profiles while controlling for several covariates.

Main Results The undiagnosed prior concussion group had higher levels of NF-L at 24–48 hours (p=.02, Cohen’s D=0.30) and asymptomatic (p=.02, Cohen’s D=0.39) timepoints relative to all diagnosed or no prior concussion groups. For those not immediately removed from activity, UCH-L1 was lower at 7 days post-return-to-activity (p=.02, Cohen’s D=0.29). No other biomarker differences were observed.

Conclusions Individuals with previously undiagnosed concussions or delayed removal from activity showed some different biomarker levels post-concussion and following clinical recovery, highlighting the importance of concussion care-seeking.

https://doi.org/10.1136/bjsports-2023-concussion.346

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