Biomarkers to aid the return to play decision following sports-related concussion: a systematic review

Premature return to play (RTP) following sports-related concussion (SRC) is associated with significant morbidity including risk of neurological and non-neurological injury, persistent post-concussion symptoms chronic deficits. Assessing athletes for RTP critical but these decisions are currently based on clinical assessments that subject bias symptomatic reporting rely compliance. An objective easily obtained biomarker can indicate recovery SRC would aid clinicians make safer decisions. We performed a systematic review identify potential biomarkers from saliva, urine blood sources could inform the decision. The MEDLINE database was searched. Inclusion criteria were studies focusing adults diagnosed SRC, fluid blood, saliva or at RTP. assessed each their time course post relationship recovery. Secondary outcomes included correlation symptom scores predictive value prolonged identified 8 all investigating blood-based markers diffuse axonal injury (tau, NFL, SNTF), neuroglial (NSE, VLP-1, UCH-L1, S100B, GFAP), inflammation hormonal disturbances. Tau, SNTF, UCH-1, GFAP, S100B inflammatory cytokine MCP-4 raised baseline by Changes in tau, GFAP correlate severity as measured duration. There only preliminary case-reporting biomarkers. evidence limited lack highly powered studies, variation use athletic Contact sport controls (CSC) consistent sampling assessment protocols. promise most notably alongside allow greater precision identifying mild severe concussion.