Research Letter: Relationship of Blood Biomarkers of Inflammation With Acute Concussion Symptoms and Recovery in the CARE Consortium.
Timothy B Meier, Daniel L Huber, Bryna D Goeckner and 6 others
PMID 38833710WHAT IT FOUND
Blood inflammation markers did not predict how long concussion recovery took.
However, higher levels of one marker (IL-1RA) in the first two days were linked to more depression and somatic symptoms, particularly in male athletes.
Key findings
01Inflammatory markers were not associated with the time it took to start or complete return-to-play protocols.
02Higher levels of IL-1RA at 12–36 hours post-injury were associated with greater psychological distress, depression, and somatization in athletes.
03In female participants, higher IL-8 at 0–12 hours was associated with a longer time to unrestricted return-to-play.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was observational, so it cannot prove that inflammation causes symptoms or delays recovery. The primary hypothesis regarding IL-6 and IL-1RA predicting recovery was null; significant findings came from secondary or exploratory analyses, which are more prone to chance. Sub-analyses for female and cadet participants had smaller sample sizes (approximately 20% of the cohort each), reducing the certainty of findings in those groups. One significant finding regarding IL-1RA and symptoms in female participants was driven by a single data point and disappeared when that participant was removed. The Brief Symptom Inventory (BSI) was not collected in the immediate 0–12 hour window, so the link between early inflammation and psychological distress could not be tested at the time when markers were most elevated.
Declared interests
Dr. Meier receives compensation from Quadrant Biosciences Inc. Dr. Broglio has current funding from NIH, CDC, DoD, and NCAA, and past funding from various sports and medical organizations. Dr. McCrea reports funding from NIH, DoD, VA, CDC, NFL, NCAA, and Abbott Laboratories, and serves as a consultant for Neurotrauma Sciences and the Green Bay Packers. Dr. Harezlak reports funding from NIH, DoD, and NCAA.
The easy way to misread this
Do not assume that elevated inflammation markers in the first 12 hours will predict a slower recovery or longer return-to-play timeline. The study found no such association for the primary markers, and the significant findings related to symptoms emerged later (12–36 hours) and were exploratory.