{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:33:44Z","timestamp":1788363224325,"version":"build-2803163510"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This prospective observational cohort study of high-school football athletes was performed to determine if high-acceleration head impacts (HHIs) that do not result in clinically diagnosed concussion still lead to increases in serum levels of biomarkers indicating traumatic brain injury (TBI) in asymptomatic athletes and to determine the longitudinal profile of these biomarkers over the course of the football season.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Sixteen varsity high-school football athletes underwent baseline neurocognitive testing and blood sampling for the biomarkers tau, ubiquitin C-terminal hydrolase L1 (UCH-L1), neurofilament light protein (NF-L), glial fibrillary acidic protein (GFAP), and spectrin breakdown products (SBDPs). All athletes wore helmet-based accelerometers to measure and record head impact data during all practices and games. At various time points during the season, 6 of these athletes met the criteria for HHI (linear acceleration &gt; 95\n                      <jats:italic>g<\/jats:italic>\n                      and rotational acceleration &gt; 3760 rad\/sec\n                      <jats:sup>2<\/jats:sup>\n                      ); in these athletes a second blood sample was drawn at the end of the athletic event during which the HHI occurred. Five athletes who did not meet the criteria for HHI underwent repeat blood sampling following the final game of the season. In a separate analysis, all athletes who did not receive a diagnosis of concussion during the season (n = 12) underwent repeat neurocognitive testing and blood sampling after the end of the season.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Total tau levels increased 492.6% \u00b1 109.8% from baseline to postsession values in athletes who received an HHI, compared with 164% \u00b1 35% in athletes who did not receive an HHI (p = 0.03). Similarly, UCH-L1 levels increased 738.2% \u00b1 163.3% in athletes following an HHI, compared with 237.7% \u00b1 71.9% in athletes in whom there was no HHI (p = 0.03). At the end of the season, researchers found that tau levels had increased 0.6 \u00b1 0.2 pg\/ml (p = 0.003) and UCH-L1 levels had increased 144.3 \u00b1 56 pg\/ml (p = 0.002). No significant elevations in serum NF-L, GFAP, or SBDPs were seen between baseline and end-of\u2013athletic event or end-of-season sampling (for all, p &gt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In this pilot study on asymptomatic football athletes, an HHI was associated with increased markers of neuronal (UCH-L1) and axonal (tau) injury when compared with values in control athletes. These same markers were also increased in nonconcussed athletes following the football season.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2017.12.jns172386","type":"journal-article","created":{"date-parts":[[2018,7,3]],"date-time":"2018-07-03T04:01:29Z","timestamp":1530590489000},"page":"1642-1648","source":"Crossref","is-referenced-by-count":42,"title":["Elevated markers of brain injury as a result of clinically asymptomatic high-acceleration head impacts in high-school football athletes"],"prefix":"10.3171","volume":"130","author":[{"given":"Jacob R.","family":"Joseph","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennylee S.","family":"Swallow","sequence":"additional","affiliation":[{"name":"NeuroTrauma Research Laboratory,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylene","family":"Willsey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Lapointe","sequence":"additional","affiliation":[{"name":"NeuroTrauma Research Laboratory,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shokoufeh","family":"Khalatbari","sequence":"additional","affiliation":[{"name":"Michigan Institute for Clinical and Health Research, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick K.","family":"Korley","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Oppenlander","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Szerlip","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven P.","family":"Broglio","sequence":"additional","affiliation":[{"name":"NeuroTrauma Research Laboratory,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.3171\/2013.7.JNS121822","article-title":"Role of subconcussion in repetitive mild traumatic brain injury","volume":"119","author":"Bailes JE","year":"2013","unstructured":"Bailes JE, Petraglia AL, Omalu BI, Nauman E, Talavage T: Role of subconcussion in repetitive mild traumatic brain injury. 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