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PLoS One. 2014 Jan 8;9(1):e84977. doi: 10.1371/journal.pone.0084977. eCollection 2014.

Subject-specific increases in serum S-100B distinguish sports-related concussion from sports-related exertion.

Author information

1
Department of Trauma Surgery, Klinikum der Universität München, Ludwig-Maximilians Universität, München, Germany.
2
Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York, United States of America.
3
Department of Neurosurgery, Klinikum der Universität München, Ludwig-Maximilians Universität, München, Germany.
4
Department of Athletics and Recreation, University of Rochester, Rochester, New York, United States of America.
5
Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, United States of America.
6
Department of Trauma Surgery, Technical University of Munich, München, Germany.

Abstract

BACKGROUND:

The on-field diagnosis of sports-related concussion (SRC) is complicated by the lack of an accurate and objective marker of brain injury.

PURPOSE:

To compare subject-specific changes in the astroglial protein, S100B, before and after SRC among collegiate and semi-professional contact sport athletes, and compare these changes to differences in S100B before and after non-contact exertion.

STUDY DESIGN:

Longitudinal cohort study.

METHODS:

From 2009-2011, we performed a prospective study of athletes from Munich, Germany, and Rochester, New York, USA. Serum S100B was measured in all SRC athletes at pre-season baseline, within 3 hours of injury, and at days 2, 3 and 7 post-SRC. Among a subset of athletes, S100B was measured after non-contact exertion but before injury. All samples were collected identically and analyzed using an automated electrochemiluminescent assay to quantify serum S100B levels.

RESULTS:

Forty-six athletes (30 Munich, 16 Rochester) underwent baseline testing. Thirty underwent additional post-exertion S100B testing. Twenty-two athletes (16 Rochester, 6 Munich) sustained a SRC, and 17 had S100B testing within 3 hours post-injury. The mean 3-hour post-SRC S100B was significantly higher than pre-season baseline (0.099±0.008 µg/L vs. 0.058±0.006 µg/L, p = 0.0002). Mean post-exertion S100B was not significantly different than the preseason baseline. S100B levels at post-injury days 2, 3 and 7 were significantly lower than the 3-hour level, and not different than baseline. Both the absolute change and proportional increase in S100B 3-hour post-injury were accurate discriminators of SRC from non-contact exertion without SRC (AUC 0.772 and 0.904, respectively). A 3-hour post-concussion S100B >0.122 µg/L and a proportional S100B increase of >45.9% over baseline were both 96.7% specific for SRC.

CONCLUSIONS:

Relative and absolute increases in serum S100B can accurately distinguish SRC from sports-related exertion, and may be a useful adjunct to the diagnosis of SRC.

PMID:
24416325
PMCID:
PMC3885765
DOI:
10.1371/journal.pone.0084977
[Indexed for MEDLINE]
Free PMC Article

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