Elevated cerebrospinal fluid total tau in former professional athletes with multiple concussions

Area of Science:

• Neuroscience
• Biomarkers
• Sports Medicine

Background:

• Repeated concussions in athletes can lead to long-term neurological issues.
• White matter (WM) integrity and cognitive function are crucial indicators of brain health.
• Cerebrospinal fluid (CSF) biomarkers may offer insights into concussion-related brain changes.

Purpose of the Study:

• To identify CSF biomarkers linked to decreased WM integrity and cognitive deficits in former professional athletes with a history of multiple concussions.
• To investigate the relationship between CSF total tau (t-tau) levels and neurological outcomes in this population.

Main Methods:

• CSF samples were analyzed for phosphorylated tau181, total tau (t-tau), and β-amyloid in former athletes, healthy controls, and Alzheimer disease patients.
• Diffusion tensor imaging assessed WM tract integrity in former athletes.
• Neuropsychological testing, including the Trail Making Test (TMT) Part B, evaluated cognitive performance.
• Former athletes were stratified into groups based on normal (<300 pg/mL) and high (>300 pg/mL) CSF t-tau concentrations.

Main Results:

• CSF t-tau was significantly higher in former athletes compared to healthy controls but lower than in Alzheimer disease patients.
• Former athletes with high CSF t-tau exhibited significantly reduced WM integrity (lower fractional anisotropy).
• High CSF t-tau was associated with significantly lower scores on the TMT Part B, indicating poorer cognitive performance.

Conclusions:

• Former athletes with multiple concussions have an increased risk of elevated CSF t-tau.
• Elevated CSF t-tau in this cohort is associated with compromised white matter integrity and impaired cognitive function.
• CSF t-tau may serve as a potential biomarker for detecting neurological changes in athletes with a history of concussions.