Effects of interval exercise and diurnal variation on blood biomarkers for sport-related concussion: A crossover cohort study

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OBJECTIVES: Preliminary investigation of exercise and diurnal effects on neurofilament light, glial fibrillary acidic protein, ubiquitin carboxy-terminal hydrolase L1 and total tau. METHODS: Plasma biomarkers were assayed from blood drawn before, during, immediately following, and 1, 2, 4, 6, 8, 24, and 48-h following three exercise conditions completed on a cycle ergometer (control [stationary], moderate intensity interval training and high intensity interval training). Participants with no prior concussion history completed each condition randomized four weeks apart. DESIGN: Observational, crossover cohort. RESULTS: Two-hundred-and-ninety-three plasma specimens from 10 participants (7 female, 3 male; median age 23.79 years (interquartile range: 21.38, 25.12)) demonstrated transient decreases in neurofilament light immediately following moderate (-1.11 pg/mL, 95 % confidence interval: -2.08 to -0.13, p = 0.03) and high intensity interval exercise (-1.48 pg/mL, 95 % confidence interval: -2.54 to -0.42, p = 0.01). Glial fibrillary acidic protein also decreased immediately following moderate (-16.47 pg/mL, 95% confidence interval: -28.88 to -4.06, p = 0.01) and high intensity interval exercise (-22.85 pg/mL, 95 % confidence interval: -30.25 to -15.45, p < 0.01), returning to control levels by 1 h post-exercise. Total tau declined throughout the day across all conditions on average (8 h: -1.15 pg/mL, β: 0.63, 95 % confidence interval: 0.44 to 0.89, p < 0.001). CONCLUSIONS: These preliminary findings highlight potential considerations for future sport-related concussion biomarker investigations collecting acute post-injury data in a sports context, as exercise may have immediate transient effects, and diurnal variations may affect plasma concentrations. Future research is needed to examine blood biomarkers affected by exercise and sport-related concussion in populations with consideration for concussion history, age, and sex.

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