PTOTSLPCohortThe Journal of head trauma rehabilitation2025

Sex Differences in Subacute Blood Biomarker Levels and Associations With Post-Concussion Symptom Severity in Adolescents With Concussion.

Mia Pasini, Gerard Gioia, Frederick Rivara and 5 others

PMID 41369614

WHAT IT FOUND

In adolescents with concussion, females had higher tau levels than males.

Biomarkers linked to symptoms differently by sex: p-tau181 correlated with cognitive issues in both, but NFL and UCH-L1 predicted physical symptoms in males and emotional symptoms in females. These are associations, not diagnostic tools.

Key findings

01Females had significantly higher adjusted tau levels (6.18 pg/mL) than males (4.5 pg/mL), while males had a higher p-tau181/tau ratio.

02Elevated p-tau181 was associated with increased cognitive symptoms in both males and females, though the association was stronger in males.

03NFL and UCH-L1 levels were associated with physical symptoms in males, but with emotional symptoms in females.

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 collected blood samples over a wide window (7 to 35 days post-injury), which may introduce variability as biomarker levels change dynamically during recovery. Biomarkers were measured at only one timepoint, preventing analysis of longitudinal changes and their relationship to symptom resolution. Menstrual status and hormonal data were incomplete, limiting the ability to analyze how hormonal fluctuations influence biomarker expression. Peripheral injuries (e.g., musculoskeletal trauma) that can affect biomarker levels were not recorded, potentially confounding the results. The study reports associations between biomarkers and symptoms, but cannot establish causality or clinical utility for diagnosis or prognosis.

Declared interests

The study was supported by the National Institute of Neurological Disorders and Stroke (N.I.H., Extramural). The authors declared no conflicts of interest.

The easy way to misread this

Do not interpret these biomarker associations as evidence that blood tests can currently diagnose concussion severity or guide clinical decision-making. The findings are from a single timepoint in a research setting and do not represent validated clinical tools.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →