{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:15:15Z","timestamp":1791350115514,"version":"4.3.1"},"reference-count":79,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>\n                    Blood-based brain biomarkers (BBM) such as glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have potential to aid in the diagnosis of concussion. Recently developed point-of-care test devices would enable BBMs to be measured in field settings such military and sport environments within minutes of a suspicious head hit. However, head hits in these environments typically occur in the setting of vigorous physical exertion, which can itself increase BBMs levels. Thus, efforts to develop BBMs as acute concussion aids in field settings need to account for the effects of physical exertion. To determine the acute effects of physical exertion on the BBMs, we measured GFAP, UCH-L1, tau, and neurofilament light chain (NF-L) immediately before, immediately after, and 45\u2009min after a single workout session consisting of aerobic and resistance exercises in 30 collegiate football players. Subjects wore body sensors measuring several aspects of exertion and underwent diffusion tensor imaging 24\u2009h before and 48\u2009h after exertion. All subjects were male with a mean age of 19.5\u2009\u00b1\u20091.2 years. The mean duration of activity during the workout session was 94\u2009\u00b1\u200931\u2009min. There was a significant decrease in serum GFAP immediately after (median decrease of 27.76%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001) and a significant increase in serum UCH-L1 45\u2009min after (median increase of 37.11%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.016) exertion, compared with pre-exertion baseline. No significant changes in tau or NF-L were identified. The duration of exertion had a significant independent linear correlation to the increase in serum UCHL1 from pre-exertion to 45\u2009min after exertion (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u2009=\u20090.68,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.004). There were no significant pre- to post-exertional changes in any of the 39 examined brain white matter regions, and biomarker changes did not correlate to variation in white matter integrity in any of these regions. Thus, exertion appeared to be associated with immediate decreases in serum GFAP and very acute (45\u2009min) increases in UCH-L1. These changes were related to the duration of exertion, but not to changes in brain white matter integrity. Our results have important implications for how these BBMs might be used to aid in the on-scene diagnosis of concussion occurring in the setting of physical exertion.\n                  <\/jats:p>","DOI":"10.1089\/neu.2022.0267","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T07:25:54Z","timestamp":1665041154000},"page":"693-705","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Effects of Physical Exertion on Early Changes in Blood-Based Brain Biomarkers: Implications for the Acute Point of Care Diagnosis of Concussion"],"prefix":"10.1177","volume":"40","author":[{"given":"Jeffrey J.","family":"Bazarian","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beau","family":"Abar","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kian","family":"Merchant-Borna","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dzung L.","family":"Pham","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Rozen","sequence":"additional","affiliation":[{"name":"Department of Athletics and Recreation, University of Rochester, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Mannix","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kawata","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Indiana University, Bloomington, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyu","family":"Chou","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Henry M. 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