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Antrobus MR, Brazier J, Callus P, Herbert AJ, Stebbings GK, Day SH, Kilduff LP, Bennett MA, Erskine RM, Raleigh SM, Collins M, Pitsiladis YP, Heffernan SM, Williams AG. Concussion-Associated Gene Variant COMT rs4680 Is Associated With Elite Rugby Athlete Status. Clin J Sport Med 2023; 33:e145-e151. [PMID: 35350037 DOI: 10.1097/jsm.0000000000001030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 02/22/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Concussions are common match injuries in elite rugby, and reports exist of reduced cognitive function and long-term health consequences that can interrupt or end a playing career and produce continued ill health. The aim of this study was to investigate the association between elite rugby status and 8 concussion-associated risk polymorphisms. We hypothesized that concussion-associated risk genotypes and alleles would be underrepresented in elite rugby athletes compared with nonathletes. DESIGN A case-control genetic association study. SETTING Institutional (university). PARTICIPANTS Elite White male rugby athletes [n = 668, mean (SD) height 1.85 (0.07) m, mass 102 (12) kg, and age 29 (7) years] and 1015 nonathlete White men and women (48% men). INTERVENTIONS Genotype was the independent variable, obtained by PCR of genomic DNA using TaqMan probes. MAIN OUTCOME MEASURE Elite athlete status with groups compared using χ 2 and odds ratio (OR). RESULTS The COMT rs4680 Met/Met (AA) genotype, Met allele possession, and Met allele frequency were lower in rugby athletes (24.8%, 74.6%, and 49.7%, respectively) than nonathletes (30.2%, 77.6%, and 54.0%; P < 0.05). The Val/Val (GG) genotype was more common in elite rugby athletes than nonathletes (OR 1.39, 95% confidence interval 1.04-1.86). No other polymorphism was associated with elite athlete status. CONCLUSIONS Elite rugby athlete status is associated with COMT rs4680 genotype that, acting pleiotropically, could affect stress resilience and behavioral traits during competition, concussion risk, and/or recovery from concussion. Consequently, assessing COMT rs4680 genotype might aid future individualized management of concussion risk among athletes.
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Affiliation(s)
- Mark R Antrobus
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Sport and Exercise Science, University of Northampton, Northampton, United Kingdom
| | - Jon Brazier
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Department of Psychology and Sports Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Peter Callus
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Adam J Herbert
- School of Health Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Georgina K Stebbings
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Stephen H Day
- Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Liam P Kilduff
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Mark A Bennett
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Robert M Erskine
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
| | - Stuart M Raleigh
- School of Health Sciences, Coventry University, Coventry, United Kingdom
| | - Malcolm Collins
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa ; and
| | - Yannis P Pitsiladis
- FIMS Reference Collaborating Centre of Sports Medicine for Anti-Doping Research, University of Brighton, Brighton, United Kingdom
| | - Shane M Heffernan
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Alun G Williams
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
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2
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McIver KG, Lee P, Bucherl S, Talavage TM, Myer GD, Nauman EA. Design Considerations for the Attenuation of Translational and Rotational Accelerations in American Football Helmets. J Biomech Eng 2023; 145:061008. [PMID: 36628996 PMCID: PMC10782865 DOI: 10.1115/1.4056653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 01/05/2023] [Accepted: 01/07/2023] [Indexed: 01/12/2023]
Abstract
Participants in American football experience repetitive head impacts that induce negative changes in neurocognitive function over the course of a single season. This study aimed to quantify the transfer function connecting the force input to the measured output acceleration of the helmet system to provide a comparison of the impact attenuation of various modern American football helmets. Impact mitigation varied considerably between helmet models and with location for each helmet model. The current data indicate that helmet mass is a key variable driving force attenuation, however flexible helmet shells, helmet shell cutouts, and more compliant padding can improve energy absorption.
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Affiliation(s)
- Kevin G. McIver
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907
| | - Patrick Lee
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907
| | - Sean Bucherl
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907
| | - Thomas M. Talavage
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221; School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907
| | - Gregory D. Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA 30542; Emory Sports Medicine Center, Atlanta, GA 30329; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30329; The Micheli Center for Sports Injury Prevention, Waltham, MA 02452
| | - Eric A. Nauman
- Dane A. and Mary Louise Miller Professor Department of Biomedical Engineering, College of Engineering and Applied Science, University of Cincinnati, 2901 Woodside Drive, Cincinnati, OH 45221
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Lippa SM, Lange RT, Dalgard CL, Soltis AR, Guedes VA, Brickell TA, French LM, Gill J. APOE Is Associated With Serum Tau Following Uncomplicated Mild Traumatic Brain Injury. Front Neurol 2022; 13:816625. [PMID: 35911887 PMCID: PMC9329522 DOI: 10.3389/fneur.2022.816625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives APOE e4 has been linked to poor outcome following traumatic brain injury (TBI); however, the mechanisms behind this relationship are unclear. Few studies have investigated the relationship between the APOE genotype and established brain related protein biomarkers following TBI. The purpose of this study was to examine this relationship in service members and veterans (SMVs) following TBI. Methods Participants were 209 SMVs [124 uncomplicated mild TBI (mTBI); 85 complicated mild, moderate, severe, or penetrating TBI (mod-sev TBI)] prospectively enrolled in the DVBIC-TBICoE 15-Year Longitudinal TBI Study. APOE genotyping was undertaken using non-fasting blood serum samples. Participants were divided into three groups: APOE e2+, APOE e3/e3, and APOE e4+. Results In participants with mTBI, those with the APOE e2 allele had significantly lower levels of tau than those with APOE e4 (p = 0.005, r = 0.43, medium-large effect size). Those with APOE e3/e3 trended toward having higher tau than those APOE e2+ (p = 0.076, r = 0.20, small-medium effect size) and lower tau than those with APOE e4+ (p = 0.062, r = 0.21, small-medium effect size). There were no significant differences in biomarkers based on APOE in the mod-sev TBI group. Discussion This study is the first to demonstrate APOE genotype is related to serum tau levels following a mTBI, extending prior findings to human serum following mTBI. In addition to higher serum tau levels in APOE e4 carriers, lower tau levels were observed in APOE e2 carriers, suggesting a possible protective effect.
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Affiliation(s)
- Sara M. Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Rael T. Lange
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
- Department of Research, Tramatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Centre of Excellence on Post-traumatic Stress Disorder, Ottawa, ON, Canada
- General Dynamics Information Technology, Falls Church, VA, United States
| | - Clifton L. Dalgard
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The American Genome Center, Bethesda, MD, United States
| | - Anthony R. Soltis
- Henry M. Jackson Foundation, Bethesda, MD, United States
- PRIMER, Bethesda, MD, United States
| | | | - Tracey A. Brickell
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
- Department of Research, Tramatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Centre of Excellence on Post-traumatic Stress Disorder, Ottawa, ON, Canada
- General Dynamics Information Technology, Falls Church, VA, United States
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Louis M. French
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
- Department of Research, Tramatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Jessica Gill
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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Griswold AJ, Correa D, Kaplan LD, Best TM. Using Genomic Techniques in Sports and Exercise Science: Current Status and Future Opportunities. Curr Sports Med Rep 2021; 20:617-623. [PMID: 34752437 DOI: 10.1249/jsr.0000000000000908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT The past two decades have built on the successes of the Human Genome Project identifying the impact of genetics and genomics on human traits. Given the importance of exercise in the physical and psychological health of individuals across the lifespan, using genomics to understand the impact of genes in the sports medicine field is an emerging field. Given the complexity of the systems involved, high-throughput genomics is required to understand genetic variants, their functions, and ultimately their effect on the body. Consequently, genomic studies have been performed across several domains of sports medicine with varying degrees of success. While the breadth of these is great, they focus largely on the following three areas: 1) performance; 2) injury susceptibility; and 3) sports associated chronic conditions, such as osteoarthritis. Herein, we review literature on genetics and genomics in sports medicine, offer suggestions to bolster existing studies, and suggest ways to ideally impact clinical care.
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Affiliation(s)
| | | | - Lee D Kaplan
- Department of Orthopedic Surgery, UHealth Sports Medicine Institute, University of Miami, Miller School of Medicine, Miami, FL
| | - Thomas M Best
- Department of Orthopedic Surgery, UHealth Sports Medicine Institute, University of Miami, Miller School of Medicine, Miami, FL
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Antrobus MR, Brazier J, Stebbings GK, Day SH, Heffernan SM, Kilduff LP, Erskine RM, Williams AG. Genetic Factors That Could Affect Concussion Risk in Elite Rugby. Sports (Basel) 2021; 9:19. [PMID: 33499151 PMCID: PMC7910946 DOI: 10.3390/sports9020019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/11/2021] [Accepted: 01/18/2021] [Indexed: 11/16/2022] Open
Abstract
Elite rugby league and union have some of the highest reported rates of concussion (mild traumatic brain injury) in professional sport due in part to their full-contact high-velocity collision-based nature. Currently, concussions are the most commonly reported match injury during the tackle for both the ball carrier and the tackler (8-28 concussions per 1000 player match hours) and reports exist of reduced cognitive function and long-term health consequences that can end a playing career and produce continued ill health. Concussion is a complex phenotype, influenced by environmental factors and an individual's genetic predisposition. This article reviews concussion incidence within elite rugby and addresses the biomechanics and pathophysiology of concussion and how genetic predisposition may influence incidence, severity and outcome. Associations have been reported between a variety of genetic variants and traumatic brain injury. However, little effort has been devoted to the study of genetic associations with concussion within elite rugby players. Due to a growing understanding of the molecular characteristics underpinning the pathophysiology of concussion, investigating genetic variation within elite rugby is a viable and worthy proposition. Therefore, we propose from this review that several genetic variants within or near candidate genes of interest, namely APOE, MAPT, IL6R, COMT, SLC6A4, 5-HTTLPR, DRD2, DRD4, ANKK1, BDNF and GRIN2A, warrant further study within elite rugby and other sports involving high-velocity collisions.
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Affiliation(s)
- Mark R. Antrobus
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK; (J.B.); (G.K.S.); (A.G.W.)
- Sport and Exercise Science, University of Northampton, Northampton NN1 5PH, UK
| | - Jon Brazier
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK; (J.B.); (G.K.S.); (A.G.W.)
- Department of Psychology and Sports Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Georgina K. Stebbings
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK; (J.B.); (G.K.S.); (A.G.W.)
| | - Stephen H. Day
- Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton WV1 1LY, UK;
| | - Shane M. Heffernan
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea SA1 8EN, UK; (S.M.H.); (L.P.K.)
| | - Liam P. Kilduff
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea SA1 8EN, UK; (S.M.H.); (L.P.K.)
| | - Robert M. Erskine
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK;
- Institute of Sport, Exercise and Health, University College London, London WC1E 6BT, UK
| | - Alun G. Williams
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK; (J.B.); (G.K.S.); (A.G.W.)
- Institute of Sport, Exercise and Health, University College London, London WC1E 6BT, UK
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Abrahams S, McFie S, Lacerda M, Patricios J, Suter J, September AV, Posthumus M. Unravelling the interaction between the DRD2 and DRD4 genes, personality traits and concussion risk. BMJ Open Sport Exerc Med 2019; 5:e000465. [PMID: 30815277 PMCID: PMC6361366 DOI: 10.1136/bmjsem-2018-000465] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2018] [Indexed: 12/27/2022] Open
Abstract
Background Concussion occurs when biomechanical forces transmitted to the head result in neurological deficits. Personality may affect the balance between safe and dangerous play potentially influencing concussion risk. Dopamine receptor D2 (DRD2) and dopamine receptor D4 (DRD4) genetic polymorphisms were previously associated with personality traits. Objectives This case-control genetic association study investigated the associations of (1) DRD2 and DRD4 genotypes with concussion susceptibility and personality, (2) personality with concussion susceptibility and (3) the statistical model of genotype, personality and concussion susceptibility. Methods In total, 138 non-concussed controls and 163 previously concussed cases were recruited from high school (n=135, junior), club and professional rugby teams (n=166, senior). Participants were genotyped for DRD2 rs12364283 (A>G), DRD2 rs1076560 (C>A) and DRD4 rs1800955 (T>C) genetic variants. Statistical analyses including structural equation modelling were performed using the R environment and STATA. Results The rs1800955 CC genotype (p=0.014) and inferred DRD2 (rs12364283-rs1076560)-DRD4 (rs1800955) A-C-C allele combination (p=0.019) were associated with decreased concussion susceptibility in juniors. The rs1800955 TT and CT genotypes were associated with low reward dependence in juniors (p<0.001) and seniors (p=0.010), respectively. High harm avoidance was associated with decreased concussion susceptibility in juniors (p=0.009) and increased susceptibility in seniors (p=0.001). The model showed that a genetic variant was associated with personality while personality was associated with concussion susceptibility. Conclusion These findings highlight the linear relationship between genetics, personality and concussion susceptibility. Identifying a genetic profile of 'high risk' behaviour, together with the development of personalised behavioural training, can potentially reduce concussion risk.
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Affiliation(s)
- Shameemah Abrahams
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa.,Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sarah McFie
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Miguel Lacerda
- Department of Statistical Sciences, Faculty of Science, University of Cape Town, Cape Town, South Africa
| | - Jon Patricios
- Sports Concussion South Africa, Johannesburg, South Africa.,Section of Sports Medicine, University of Pretoria, Pretoria, South Africa.,Department of Emergency Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Jason Suter
- Cape Sports Medicine, Sports Science Institute, Cape Town, South Africa
| | - Alison V September
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Michael Posthumus
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
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McGrew CA. Sports-related Concussion - Genetic Factors. Curr Sports Med Rep 2019; 18:20-22. [PMID: 30624331 DOI: 10.1249/jsr.0000000000000555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Genetic biomarkers have been evaluated for validity in predicting risk for sports-related concussion as well as prognosticating recovery from this injury. Research results from predominantly small-scale pilot studies thus far are mixed and preliminary findings have not been adequately replicated. Currently, the use of such genetic biomarkers should be considered investigational and not for routine clinical use.
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Affiliation(s)
- Christopher A McGrew
- Department of Family and Community Medicine, Department of Orthopedics and Rehabilitation, University of New Mexico Health Sciences Center, Albuquerque, NM
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Deng H, Ordaz A, Upadhyayula PS, Gillis-Buck EM, Suen CG, Melhado CG, Mohammed N, Lam T, Yue JK. Apolipoprotein E Epsilon 4 Genotype, Mild Traumatic Brain Injury, and the Development of Chronic Traumatic Encephalopathy. Med Sci (Basel) 2018; 6:E78. [PMID: 30223506 PMCID: PMC6163513 DOI: 10.3390/medsci6030078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 09/04/2018] [Accepted: 09/12/2018] [Indexed: 12/14/2022] Open
Abstract
The annual incidence of mild traumatic brain injury (MTBI) is 3.8 million in the USA with 10⁻15% experiencing persistent morbidity beyond one year. Chronic traumatic encephalopathy (CTE), a neurodegenerative disease characterized by accumulation of hyperphosphorylated tau, can occur with repetitive MTBI. Risk factors for CTE are challenging to identify because injury mechanisms of MTBI are heterogeneous, clinical manifestations and management vary, and CTE is a postmortem diagnosis, making prospective studies difficult. There is growing interest in the genetic influence on head trauma and development of CTE. Apolipoprotein epsilon 4 (APOE-ε4) associates with many neurologic diseases, and consensus on the ε4 allele as a risk factor is lacking. This review investigates the influence of APOE-ε4 on MTBI and CTE. A comprehensive PubMed literature search (1966 to 12 June 2018) identified 24 unique reports on the topic (19 MTBI studies: 8 athletic, 5 military, 6 population-based; 5 CTE studies: 4 athletic and military, 1 leucotomy group). APOE-ε4 genotype is found to associate with outcomes in 4/8 athletic reports, 3/5 military reports, and 5/6 population-based reports following MTBI. Evidence on the association between APOE-ε4 and CTE from case series is equivocal. Refining modalities to aid CTE diagnosis in larger samples is needed in MTBI.
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Affiliation(s)
- Hansen Deng
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94122, USA.
| | - Angel Ordaz
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94122, USA.
| | - Pavan S Upadhyayula
- Department of Neurological Surgery, University of California San Diego, San Diego, CA 92093, USA.
| | - Eva M Gillis-Buck
- Department of Surgery, University of California San Francisco, San Francisco, CA 94122, USA.
- Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA.
| | - Catherine G Suen
- Department of Neurology, University of Utah, Salt Lake City, UT 84112, USA.
| | - Caroline G Melhado
- Department of Surgery, University of California San Francisco, San Francisco, CA 94122, USA.
| | - Nebil Mohammed
- Department of Pathology, University of California San Francisco, San Francisco, CA 94122, USA.
| | - Troy Lam
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, CA 94122, USA.
| | - John K Yue
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94122, USA.
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Abrahams S, Mc Fie S, Patricios J, Suter J, September AV, Posthumus M. Toxic tau: The TAU gene polymorphisms associate with concussion history in rugby union players. J Sci Med Sport 2018; 22:22-28. [PMID: 30554614 DOI: 10.1016/j.jsams.2018.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/25/2018] [Accepted: 06/13/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Concussion is a brain injury that occurs when biomechanical forces are transmitted to the head region resulting in neurological deficits. The accumulation of tau protein in autopsies of athletes with multiple concussions implicates tau in concussion-associated neurodegeneration. The TAU rs2435211 (C>T) and rs2435200 (G>A) polymorphisms are involved in pathological tau expression and neurodegenerative disease risk. The aims of this study were to investigate the associations of TAU (rs2435211, rs2435200) polymorphisms with concussion history and sustaining multiple concussions in rugby. DESIGN In total, 140 non-concussed controls and 163 previously concussed participants (all cases group, N=163; clinically diagnosed, N=140; multiple concussed, N=87) were recruited from high school (N=135, junior), club and professional rugby teams (N=166, senior). METHODS Participants were genotyped for TAU rs2435211 and rs2435200 polymorphisms. RESULTS In seniors, the rs2435200 AA genotype was significantly over-represented in the control group compared to the multiple concussed subgroup (P=0.033, control: 25%, N=16, multiple concussed: 11%, N=6; OR: 0.34, 95% CI 0.12-0.96). While the AG genotype was significantly under-represented in the control compared to multiple concussed (P=0.024, control: 45%, N=29, multiple concussed: 63%, N=36; OR: 2.34, 95% CI 1.11-4.95). The inferred TAU (rs2435211 C>T-rs2435200 G>A) T-G haplotype was significantly under-represented in the control (19%, N=12) compared to the all cases group (30%, N=28, P=0.031). CONCLUSIONS The TAU-associated neurodegenerative pathway was implicated as a potential pathophysiological mechanism underlying concussion in seniors. In future, the identification of TAU polymorphisms associated with concussion risk may assist clinical management and reduce risk of severe complications.
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Affiliation(s)
- Shameemah Abrahams
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, South Africa
| | - Sarah Mc Fie
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, South Africa
| | - Jon Patricios
- Sports Concussion South Africa, South Africa,; Section of Sports Medicine, University of Pretoria, South Africa; Department of Emergency Medicine, University of the Witwatersrand, South Africa
| | - Jason Suter
- Cape Sports Medicine, Sports Science Institute, South Africa
| | - Alison V September
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, South Africa
| | - Michael Posthumus
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, South Africa.
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