Journal Article

Brain-related proteins as serum biomarkers of acute, subconcussive blast overpressure exposure: A cohort study of military personnel

Gilsdorf, Janice, LaValle, Christina R., Thangavelu, Bharani, Shear, Deborah A., Boutté, Angela M., Kamimori, Gary H., Nemes, Jeffrey

2019

Overview

Repeated exposure to blast overpressure remains a major cause of adverse health for military personnel who, as a consequence, are at a higher risk for neurodegenerative disease and suicide. Acute, early tracking of blast related effects holds the promise of rapid health assessment prior to onset of chronic problems. Current techniques used to determine blast-related effects rely upon reporting of symptomology similar to that of concussion and neurocognitive assessment relevant to operational decrement. Here, we describe the results of a cross sectional study with pared observations. The concentration of multiple TBI-related proteins was tested in serum collected within one hour of blast exposure as a quantitative and minimally invasive strategy to augment assessment of blast-exposure effects that are associated with concussion-like symptomology and reaction time decrements. We determined that median simple reaction time (SRT) was slowed in accordance with serum Nf-L, tau, Aβ-40, and Aβ-42 elevation after overpressure exposure. In contrast, median levels of serum GFAP decreased. Individual, inter-subject analysis revealed positive correlations between changes in Nf-L and GFAP, and in Aβ-40 compared to Aβ-42. The change in Nf-L was negatively associated with tau, Aβ-40, and Aβ-42. Participants reported experiencing headaches, dizziness and taking longer to think. Dizziness was associated with reaction time decrements, GFAP or NfL suppression, as well as Aβ peptide elevation. UCH-L1 elevation had a weak association with mTBI/concussion history. Multiplexed serum biomarker quantitation, coupled with reaction time assessment and symptomology determined before and after blast exposure, may serve as a platform for tracking adverse effects in the absence of a head wound or diagnosed concussion. We propose further evaluation of serum biomarkers, which are often associated with TBI, in the context of acute operational blast exposures.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Biological markers / Biology and Life Sciences / Biomarkers / Biomarkers - blood / Blast effect / Blast Injuries - blood / Blast Injuries - pathology / Blast Injuries - physiopathology / Brain / Brain - metabolism / Brain - pathology / Brain - physiopathology / Brain Concussion - blood / Brain Concussion - pathology / Brain Concussion - physiopathology / Brain injuries / Brain research / Cognition / Cohort analysis / Cohort Studies / Concussion / Correlation analysis / Cross-Sectional Studies / Cytoskeletal proteins / Diagnosis / Explosions / Exposure / Glial fibrillary acidic protein / Headache / Health / Health aspects / Health risks / Humans / Male / Medicine and Health Sciences / Mental health / Metabolites / Military / Military Personnel / Military psychology / Nerve Tissue Proteins - blood / Nervous system / Nervous system diseases / Neurodegenerative diseases / Neurological diseases / Neurosciences / Overpressure / Peptides / Proteins / Psychiatry / Quantitation / Reaction time / Social Sciences / Suicide / Symptomology / Tau protein / Testing / Tracking / Trauma / Traumatic brain injury / Work related injuries