{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T21:26:21Z","timestamp":1787606781010,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009941","name":"Ministry of Defence","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009941","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Exercise in the heat and elevated tissue temperature are associated with neuronal stress and changes in blood\u2013brain barrier (BBB) function. More severe thermal insult may manifest as exertional heat illness (EHI) and complication by central nervous system (CNS) dysfunction may persist post\u2010EHI. We investigated neurobiomarkers associated with neuronal injury (brain\u2010derived tau, BD\u2010tau; neurofilament light, NfL; ubiquitin carboxyl\u2010terminal hydrolase isozyme L1, UCH\u2010L1) and BBB function (glial fibrillary acid protein, GFAP) in the peripheral blood of 34 recent (\u223c4\u00a0months) EHI patients and 30 Control individuals without prior EHI history, matched for variables influencing thermoregulation. Participants completed an exercise heat tolerance assessment (HTA), with neurobiomarkers measured pre\u2010 and post\u2010HTA. An equal number of participants (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a06) in both EHI and Control groups showed thermoregulatory responses consistent with thermal intolerance. Pooled changes in BD\u2010tau, GFAP and UCH\u2010L1 showed moderate to large effect sizes (Cohen's\n                    <jats:italic>d<\/jats:italic>\n                    \u00a0=\u00a01.2, \u22121.3 and 0.75, respectively), including novel elevation in BD\u2010tau (median [interquartile range] 4.84 [4.10, 5.51] vs. 6.89 [5.69, 7.85] pg\u00a0mL\n                    <jats:sup>\u22121<\/jats:sup>\n                    ), whereas impact of HTA on NfL was negligible (Cohen's\n                    <jats:italic>d<\/jats:italic>\n                    \u00a0=\u00a00.03). No differences were evident in neurobiomarker response between EHI and Controls (time \u00d7 group interaction\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.244), and no consistent associations between body core temperature and neurobiomarker concentrations were demonstrated. In conclusion, neurobiomarker responses to HTA were similar between EHI cases and Controls, indicating an absence of ongoing CNS injury in this patient cohort. However, variability in neurobiomarkers with HTA queries the general applicability of these biochemical surrogates in the management of brain insult associated with prior exercise and thermal stress.\n                  <\/jats:p>","DOI":"10.1113\/ep093598","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T21:05:36Z","timestamp":1787605536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thermoregulatory and plasma neurobiomarker responses to heat tolerance assessment in exertional heat illness and matched controls"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0540-4761","authenticated-orcid":false,"given":"Tom W.","family":"Palin","sequence":"first","affiliation":[{"name":"Carnegie School of Sport Leeds Beckett University  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6552-6471","authenticated-orcid":false,"given":"Jo","family":"Corbett","sequence":"additional","affiliation":[{"name":"Extreme Environments Laboratory, School of Psychology, Sport, and Health Sciences, Faculty of Science and Health University of Portsmouth  Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Infection, Inflammation and Immunology, College of Medicine and Health University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Woods","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport Leeds Beckett University  Leeds UK"},{"name":"Academic Department of Military Medicine Defence Medical Services Research and Innovation  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex A. M.","family":"Gould","sequence":"additional","affiliation":[{"name":"Extreme Environments Laboratory, School of Psychology, Sport, and Health Sciences, Faculty of Science and Health University of Portsmouth  Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barney","family":"Wainwright","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport Leeds Beckett University  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Infection, Inflammation and Immunology, College of Medicine and Health University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6202-1347","authenticated-orcid":false,"given":"Chloe N.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Infection, Inflammation and Immunology, College of Medicine and Health University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9916-7390","authenticated-orcid":false,"given":"Daniel","family":"Snape","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport Leeds Beckett University  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"House","sequence":"additional","affiliation":[{"name":"Extreme Environments Laboratory, School of Psychology, Sport, and Health Sciences, Faculty of Science and Health University of Portsmouth  Portsmouth UK"},{"name":"Survival and Thermal Medicine Department Institute of Naval Medicine  Gosport UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Tayari","sequence":"additional","affiliation":[{"name":"Survival and Thermal Medicine Department Institute of Naval Medicine  Gosport UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Elsworthy","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Infection, Inflammation and Immunology, College of Medicine and Health University of Birmingham  Birmingham UK"},{"name":"Academic Department of Military Medicine Defence Medical Services Research and Innovation  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-0826","authenticated-orcid":false,"given":"Andrew J.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command Ministry of Defence  Upavon UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1589-7984","authenticated-orcid":false,"given":"John P.","family":"O'Hara","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport Leeds Beckett University  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Stacey","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport Leeds Beckett University  Leeds UK"},{"name":"Academic Department of Military Medicine Defence Medical Services Research and Innovation  Birmingham UK"},{"name":"Department of Surgery and Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"issue":"9","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"5040","DOI":"10.3390\/ijms25095040","article-title":"Neuron\u2010specific enolase\u2014what are we measuring?","volume":"25","author":"Babkina A. 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