{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:15:17Z","timestamp":1791350117052,"version":"4.3.1"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230206-4\"><jats:title>Importance<\/jats:title><jats:p>Head impacts resulting in traumatic brain injury (TBI) lead to the elevation of phosphorylated tau protein (p-tau<jats:sub>181<\/jats:sub>) in plasma. To our knowledge, this study is the first to investigate dynamics of p-tau<jats:sub>181<\/jats:sub> levels and the ratio of p-tau<jats:sub>181<\/jats:sub> to total tau in individuals after nonconcussive head impacts.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230206-5\"><jats:title>Objective<\/jats:title><jats:p>To determine the association of repetitive low-intensity head impacts on p-tau<jats:sub>181<\/jats:sub> and total tau protein levels in the plasma of young adult elite soccer players and assess the possible association of head impacts with focused attention and cognitive flexibility.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230206-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In this cohort study, young elite soccer players performed intense physical activity with and without heading the ball. The study was conducted at a university facility in Slovakia from October 1, 2021, to May 31, 2022. Eligible participants were selected based on similarities in demographic variables, excluding those with a history of TBI.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230206-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary study outcomes were the levels of total tau protein and p-tau<jats:sub>181<\/jats:sub> in plasma samples and the cognitive status of the study participants.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230206-8\"><jats:title>Results<\/jats:title><jats:p>A total of 37 male athletes participated in the study (mean [SD] age: exercise group, 21.6 [1.6] years; heading group, 21.2 [1.5] years). We found significantly elevated levels of total tau and p-tau<jats:sub>181<\/jats:sub> in the plasma of soccer players 1 hour after physical exercise (tau, 1.4-fold; 95% CI, 1.2-1.5; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001; p-tau<jats:sub>181<\/jats:sub>, 1.4-fold; 95% CI, 1.3-1.5, <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) and repetitive head impacts (tau, 1.3-fold; 95% CI, 1.2-1.4; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001; p-tau<jats:sub>181<\/jats:sub>, 1.5-fold; 95% CI, 1.4-1.7 <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). The ratio of p-tau<jats:sub>181<\/jats:sub> to tau was significantly higher 1 hour after exercise and heading training, and remained elevated specifically in the heading group even after 24 hours (1.2-fold; 95% CI, 1.1-1.3; <jats:italic>P<\/jats:italic>\u2009=\u2009.002). Performance in cognitive tests revealed a significant decline in focused attention and cognitive flexibility after physical exercise and heading training; physical exercise of higher intensity without heading training was associated with a greater negative cognitive performance than heading only.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230206-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study of young elite soccer players, the elevation of p-tau<jats:sub>181<\/jats:sub> and tau was observed after acute intense physical activity and nonconcussive repetitive head impacts. The increase of p-tau<jats:sub>181<\/jats:sub> levels relative to tau after 24 hours indicated an acute enrichment of phosphorylated tau fraction in the periphery when compared with preimpact levels; an imbalance of tau proteins may have long-lasting consequences in the brain of head-impacted individuals.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.6101","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T15:16:49Z","timestamp":1680189409000},"page":"e236101","source":"Crossref","is-referenced-by-count":11,"title":["Association of Nonconcussive Repetitive Head Impacts and Intense Physical Activity With Levels of Phosphorylated Tau<sub>181<\/sub> and Total Tau in Plasma of Young Elite Soccer Players"],"prefix":"10.1001","volume":"6","author":[{"given":"Martin","family":"Cente","sequence":"first","affiliation":[{"name":"Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, 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