Subject-Specific Increases in Serum S-100B Distinguish Sports-Related Concussion from Sports-Related Exertion
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{"title"=>"Subject-specific increases in serum S-100B distinguish sports-related concussion from sports-related exertion", "type"=>"journal", "authors"=>[{"first_name"=>"Karin", "last_name"=>"Kiechle", "scopus_author_id"=>"55885513400"}, {"first_name"=>"Jeffrey J.", "last_name"=>"Bazarian", "scopus_author_id"=>"6701678812"}, {"first_name"=>"Kian", "last_name"=>"Merchant-Borna", "scopus_author_id"=>"55367063200"}, {"first_name"=>"Veit", "last_name"=>"Stoecklein", "scopus_author_id"=>"50961615800"}, {"first_name"=>"Eric", "last_name"=>"Rozen", "scopus_author_id"=>"56088786300"}, {"first_name"=>"Brian", "last_name"=>"Blyth", "scopus_author_id"=>"12042129500"}, {"first_name"=>"Jason H.", "last_name"=>"Huang", "scopus_author_id"=>"7407191671"}, {"first_name"=>"Samantha", "last_name"=>"Dayawansa", "scopus_author_id"=>"6506804393"}, {"first_name"=>"Karl", "last_name"=>"Kanz", "scopus_author_id"=>"7003802411"}, {"first_name"=>"Peter", "last_name"=>"Biberthaler", "scopus_author_id"=>"7003955692"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"24416325", "sgr"=>"84897064749", "doi"=>"10.1371/journal.pone.0084977", "scopus"=>"2-s2.0-84897064749", "pui"=>"372718722", "isbn"=>"1932-6203", "issn"=>"19326203"}, "id"=>"ca21532a-ff62-3f35-817e-afb61f12e8f1", "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 microg/L vs. 0.058+/-0.006 microg/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 microg/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.", "link"=>"http://www.mendeley.com/research/subjectspecific-increases-serum-s100b-distinguish-sportsrelated-concussion-sportsrelated-exertion", "reader_count"=>57, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>2, "Librarian"=>1, "Researcher"=>8, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>4, "Other"=>6, "Student > Master"=>6, "Student > Bachelor"=>8, "Lecturer"=>1, "Professor"=>4}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>2, "Librarian"=>1, "Researcher"=>8, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>4, "Other"=>6, "Student > Master"=>6, "Student > Bachelor"=>8, "Lecturer"=>1, "Professor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Agricultural and Biological Sciences"=>11, "Business, Management and Accounting"=>1, "Computer Science"=>1, "Engineering"=>2, "Nursing and Health Professions"=>2, "Biochemistry, Genetics and Molecular Biology"=>5, "Medicine and Dentistry"=>18, "Neuroscience"=>1, "Sports and Recreations"=>4, "Psychology"=>5, "Social Sciences"=>2, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>18}, "Social Sciences"=>{"Social Sciences"=>2}, "Sports and Recreations"=>{"Sports and Recreations"=>4}, "Psychology"=>{"Psychology"=>5}, "Unspecified"=>{"Unspecified"=>4}, "Engineering"=>{"Engineering"=>2}, "Neuroscience"=>{"Neuroscience"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>11}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>5}}, "reader_count_by_country"=>{"United States"=>2, "United Kingdom"=>1, "Australia"=>1}, "group_count"=>8}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1342471"], "description"=>"<p>Cutoff values shown are those that maximize sensitivity (†) and specificity (‡).</p>", "links"=>[], "tags"=>["Anatomy and physiology", "cardiovascular system", "Circulatory physiology", "Neurological system", "ganglia", "Clinical research design", "Cohort studies", "Longitudinal studies", "Observational studies", "Diagnostic medicine", "pathology", "General pathology", "biomarkers", "Test evaluation", "epidemiology", "Biomarker epidemiology", "neurology", "Head injury", "Sports and exercise medicine", "classification"], "article_id"=>897246, "categories"=>["Medicine"], "users"=>["Karin Kiechle", "Jeffrey J. Bazarian", "Kian Merchant-Borna", "Veit Stoecklein", "Eric Rozen", "Brian Blyth", "Jason H. Huang", "Samantha Dayawansa", "Karl Kanz", "Peter Biberthaler"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084977.t003", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Concussion_classification_using_S100B_/897246", "title"=>"Concussion classification using S100B.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-08 04:21:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1342468"], "description"=>"<p><b>A</b>: Mean changes in S100B levels among all concussed athletes at baseline and at four time points after injury. The number of athletes included in determining the mean at each time point is indicated below each box plot. The mean S100B concentration within 3 hours of SRC (0.099±0.032 µg/L) was significantly higher than that at baseline (0.058±0.025 µg/L, *p<0.0001) using a paired t-test. The 3 hour S100B level was also higher than that at 2 days (0.059±0.03 µg/L, <sup>++</sup>p = 0.0004), 3 days (0.052±0.02 µg/L, <sup>+</sup>p<0.0001), and 7 days (0.059±0.03 µg/L, **p = 0.001) post-SRC using unpaired t-tests. <b>B</b>: Longitudinal changes in S100B levels among concussed athletes who had baseline and all four post-SRC S100B measurements. All 11 of these athletes were from the Unviersity of Rochester. The mean S100B level within 3 hours of SRC (0.099±0.032 µg/L) was significantly higher than that at baseline (0.058±0.025 µg/L, *p<0.0001), and higher than that at 2 days (0.059±0.027 µg/L, ++p = 0.0047), 3 days (0.048±0.008 µg/L, +p = 0.0002), and 7 days (0.056±0.027 µg/L, **p = 0.0058) post-SRC using paired t-tests.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "cardiovascular system", "Circulatory physiology", "Neurological system", "ganglia", "Clinical research design", "Cohort studies", "Longitudinal studies", "Observational studies", "Diagnostic medicine", "pathology", "General pathology", "biomarkers", "Test evaluation", "epidemiology", "Biomarker epidemiology", "neurology", "Head injury", "Sports and exercise medicine", "s100b", "sports-related"], "article_id"=>897243, "categories"=>["Medicine"], "users"=>["Karin Kiechle", "Jeffrey J. Bazarian", "Kian Merchant-Borna", "Veit Stoecklein", "Eric Rozen", "Brian Blyth", "Jason H. Huang", "Samantha Dayawansa", "Karl Kanz", "Peter Biberthaler"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084977.g002", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Longitudinal_changes_in_S100B_before_and_after_sports_related_concussion_/897243", "title"=>"Longitudinal changes in S100B before and after sports-related concussion.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-08 04:21:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1342467"], "description"=>"<p><b>A</b>: Absolute (Left) and proportional (right) changes in S100B levels after non-contact exertion among individal athletes. The proportional change is defined as (post-exertion or 3-hour post-SRC S100B – baseline S100B)/baseline S100B (range: −35% to +50%; mean proportional change  = +2.7%). The mean post-exertional S100B concentration (0.071±0.03 µg/L) was not significantly different from mean baseline (0.070±0.03 µg/L, *p = 0.87, Middle). <b>B</b>: Absolute (Left) and proportional (right) changes in S100B levels within 3 hours of SRC among individual athletes. The mean post-SRC S100B concentration within 3 hours of concussion (0.099±0.008 µg/L) was significantly higher than that at baseline (0.058±0.006 µg/L, **p = 0.0002, Middle). Proportional change (right) ranged from −14% to +180%; mean proportional change +81.2%). Munich athletes are designated in red, Rochester athletes in black.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "cardiovascular system", "Circulatory physiology", "Neurological system", "ganglia", "Clinical research design", "Cohort studies", "Longitudinal studies", "Observational studies", "Diagnostic medicine", "pathology", "General pathology", "biomarkers", "Test evaluation", "epidemiology", "Biomarker epidemiology", "neurology", "Head injury", "Sports and exercise medicine", "non-contact", "exertion", "sports-related"], "article_id"=>897242, "categories"=>["Medicine"], "users"=>["Karin Kiechle", "Jeffrey J. Bazarian", "Kian Merchant-Borna", "Veit Stoecklein", "Eric Rozen", "Brian Blyth", "Jason H. Huang", "Samantha Dayawansa", "Karl Kanz", "Peter Biberthaler"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084977.g001", "stats"=>{"downloads"=>2, "page_views"=>26, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_S100B_Changes_after_non_contact_exertion_and_sports_related_concussion_/897242", "title"=>"S100B Changes after non-contact exertion and sports-related concussion.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-08 04:21:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1342470"], "description"=>"<p>Study overview.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "cardiovascular system", "Circulatory physiology", "Neurological system", "ganglia", "Clinical research design", "Cohort studies", "Longitudinal studies", "Observational studies", "Diagnostic medicine", "pathology", "General pathology", "biomarkers", "Test evaluation", "epidemiology", "Biomarker epidemiology", "neurology", "Head injury", "Sports and exercise medicine"], "article_id"=>897245, "categories"=>["Medicine"], "users"=>["Karin Kiechle", "Jeffrey J. Bazarian", "Kian Merchant-Borna", "Veit Stoecklein", "Eric Rozen", "Brian Blyth", "Jason H. Huang", "Samantha Dayawansa", "Karl Kanz", "Peter Biberthaler"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084977.t001", "stats"=>{"downloads"=>1, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Study_overview_/897245", "title"=>"Study overview.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-08 04:21:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1342469"], "description"=>"<p>A: The ROC using the 3-hour post-SRC value or the post-exertion S100B value revealed an AUC of 0.772 (95% CI: 0.64, 0.91). B: The AUC using the proportional increase in post-SRC/exertional S100B level over baseline was 0.904 (95% CI: 0.80, 1.0).</p>", "links"=>[], "tags"=>["Anatomy and physiology", "cardiovascular system", "Circulatory physiology", "Neurological system", "ganglia", "Clinical research design", "Cohort studies", "Longitudinal studies", "Observational studies", "Diagnostic medicine", "pathology", "General pathology", "biomarkers", "Test evaluation", "epidemiology", "Biomarker epidemiology", "neurology", "Head injury", "Sports and exercise medicine", "s100b", "sports-related"], "article_id"=>897244, "categories"=>["Medicine"], "users"=>["Karin Kiechle", "Jeffrey J. Bazarian", "Kian Merchant-Borna", "Veit Stoecklein", "Eric Rozen", "Brian Blyth", "Jason H. Huang", "Samantha Dayawansa", "Karl Kanz", "Peter Biberthaler"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084977.g003", "stats"=>{"downloads"=>6, "page_views"=>23, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Diagnostic_accuracy_of_S100B_for_sports_related_concussion_/897244", "title"=>"Diagnostic accuracy of S100B for sports-related concussion.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-08 04:21:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1342472"], "description"=>"<p>T-test to assess difference between Munich and Rochester cohorts at baseline, p = 0.85.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "cardiovascular system", "Circulatory physiology", "Neurological system", "ganglia", "Clinical research design", "Cohort studies", "Longitudinal studies", "Observational studies", "Diagnostic medicine", "pathology", "General pathology", "biomarkers", "Test evaluation", "epidemiology", "Biomarker epidemiology", "neurology", "Head injury", "Sports and exercise medicine"], "article_id"=>897247, "categories"=>["Medicine"], "users"=>["Karin Kiechle", "Jeffrey J. Bazarian", "Kian Merchant-Borna", "Veit Stoecklein", "Eric Rozen", "Brian Blyth", "Jason H. Huang", "Samantha Dayawansa", "Karl Kanz", "Peter Biberthaler"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084977.t002", "stats"=>{"downloads"=>7, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Subject_characteristics_/897247", "title"=>"Subject characteristics.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-08 04:21:01"}

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Relative Metric

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