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Sports Medicine

, Volume 47, Issue 4, pp 781–789 | Cite as

Utility of S100B Serum Level for the Determination of Concussion in Male Rugby Players

  • Damien Bouvier
  • Thomas Duret
  • Mathieu Abbot
  • Thibault Stiernon
  • Bruno Pereira
  • Aurélien Coste
  • Jean Chazal
  • Vincent SapinEmail author
Original Research Article
Part of the following topical collections:
  1. Rugby Health

Abstract

Background

The incidence of concussion in professional direct-contact sports, particularly in rugby, has increased in recent years. To date, cognitive assessment is the most common means of determining whether a concussed player can return to the game. Serum S100B assay, an objective blood test known to be useful in brain injury management, may offer a novel additional approach to the management of concussed male rugby players.

Objective

The aim of this study was to investigate the S100B utility for the determination of concussion in a professional 15-players-a-side rugby team.

Methods

Thirty-nine male rugby players were included in a prospective study during the 2014–2015 French championship season. Serum sampling was carried out several times at baseline and after a match and/or a concussion, at set times (2, 36 h). Serum S100B concentrations were determined using chemiluminescence immunoassay on a Roche Diagnostics® instrument.

Results

The players’ basal serum S100B was stable during the season and was not correlated with anthropometric data, body composition, or creatine kinase concentration. A significant increase in S100B concentration within 2 h after a game (without concussion) was observed. This increase was correlated with the number of body collisions during a match. Seventy-seven assays were performed 36 h after a game, including the follow-up of five concussed players. Thirty-six hours after a match, an increase of a minimum of 20 % compared with individual basal concentrations identified concussion with 100 % sensitivity and 81 % specificity.

Conclusion

S100B measured 36 h after a match is thus a discriminating test to identify concussion in a male rugby player, with a 100 % negative predictive value.

Keywords

Mild Traumatic Brain Injury Creatine Kinase Activity Chronic Traumatic Encephalopathy Basal Concentration S100B Protein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors would like to thank the biologists of Genbio® Laboratory for their help in blood sampling for the S100B basal determination taken on three occasions; and the Auvergne Traduction Technique (ATT) society for proofreading and editing this manuscript.

Compliance with Ethical Standards

Conflict of interest

Damien Bouvier, Thomas Duret, Thibault Stiernon, Bruno Pereira, Mathieu Abbot, Aurélien Coste, Jean Chazal, and Vincent Sapin declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Gardner AJ, Iverson GL, Williams WH, Baker S, Stanwell P. A systematic review and meta-analysis of concussion in rugby union. Sports Med. 2014;44(12):1717–31.CrossRefPubMedGoogle Scholar
  2. 2.
    McCrory P, Meeuwisse WH, Aubry M, Cantu RC, Dvorak J, Echemendia RJ, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport, Zurich, November 2012. J Athl Train. 2013;48(4):554–75.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Fraas MR, Coughlan GF, Hart EC, McCarthy C. Concussion history and reporting rates in elite Irish rugby union players. Phys Ther Sport. 2014;15(3):136–42.CrossRefPubMedGoogle Scholar
  4. 4.
    Gardner AJ, Iverson GL, Quinn TN, Makdissi M, Levi CR, Shultz SR, et al. A preliminary video analysis of concussion in the National Rugby League. Brain Inj. 2015;17:1–4. doi: 10.3109/02699052.2015.1034179.Google Scholar
  5. 5.
    Bey T, Ostick B. Second impact syndrome. West J Emerg Med. 2009;10(1):6–10.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Solomon GS, Zuckerman SL. Chronic traumatic encephalopathy in professional sports: retrospective and prospective views. Brain Injury. 2015;29(2):164–70.CrossRefPubMedGoogle Scholar
  7. 7.
    McCrory P, Meeuwisse WH, Kutcher JS, Jordan BD, Gardner A. What is the evidence for chronic concussion-related changes in retired athletes: behavioural, pathological and clinical outcomes? Br J Sports Med. 2013;47(5):327–30.CrossRefPubMedGoogle Scholar
  8. 8.
    Fuller GW, Kemp SPT, Decq P. The International Rugby Board (IRB) Pitch Side Concussion Assessment trial: a pilot test accuracy study. Br J Sports Med. 2015;49(8):529–35.CrossRefPubMedGoogle Scholar
  9. 9.
    Zimmer DB, Cornwall EH, Landar A, Song W. The S100 protein family: history, function, and expression. Brain Res Bull. 1995;37(4):417–29.CrossRefPubMedGoogle Scholar
  10. 10.
    Donato R. S100: a multigenic family of calcium-modulated proteins of the EF-hand type with intracellular and extracellular functional roles. Int J Biochem Cell Biol. 2001;33(7):637–68.CrossRefPubMedGoogle Scholar
  11. 11.
    Schulte S, Podlog LW, Hamson-Utley JJ, Strathmann FG, Struder HK. A systematic review of the biomarker S100B: implications for sport-related concussion management. J Athl Train. 2014;49(6):830–50.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Dietrich MO, Tort AB, Schaf DV, Farina M, Goncalves CA, Souza DO, et al. Increase in serum S100B protein level after a swimming race. Can J Appl Physiol Rev Can Physiol Appl. 2003;28(5):710–6.CrossRefGoogle Scholar
  13. 13.
    Otto M, Holthusen S, Bahn E, Sohnchen N, Wiltfang J, Geese R, et al. Boxing and running lead to a rise in serum levels of S-100B protein. Int J Sports Med. 2000;21(8):551–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Stalnacke B-M, Tegner Y, Sojka P. Playing ice hockey and basketball increases serum levels of S-100B in elite players: a pilot study. Clin J Sport Med. 2003;13(5):292–302.CrossRefPubMedGoogle Scholar
  15. 15.
    Stalnacke B-M, Tegner Y, Sojka P. Playing soccer increases serum concentrations of the biochemical markers of brain damage S-100B and neuron-specific enolase in elite players: a pilot study. Brain Inj. 2004;18(9):899–909.CrossRefPubMedGoogle Scholar
  16. 16.
    Koh SXT, Lee JKW. S100B as a marker for brain damage and blood-brain barrier disruption following exercise. Sports Med. 2014;44(3):369–85.CrossRefPubMedGoogle Scholar
  17. 17.
    Mussack T, Dvorak J, Graf-Baumann T, Jochum M. Serum S-100B protein levels in young amateur soccer players after controlled heading and normal exercise. Eur J Med Res. 2003;8(10):457–64.PubMedGoogle Scholar
  18. 18.
    Shahim P, Tegner Y, Wilson DH, Randall J, Skillback T, Pazooki D, et al. Blood biomarkers for brain injury in concussed professional ice hockey players. JAMA Neurol. 2014;71(6):684–92.CrossRefPubMedGoogle Scholar
  19. 19.
    Kiechle K, Bazarian JJ, Merchant-Borna K, Stoecklein V, Rozen E, Blyth B, et al. Subject-specific increases in serum S-100B distinguish sports-related concussion from sports-related exertion. PloS One. 2014;9(1):e84977.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Unden J, Romner B. Can low serum levels of S100B predict normal CT findings after minor head injury in adults? An evidence-based review and meta-analysis. J Head Trauma Rehabil. 2010;25(4):228–40.CrossRefPubMedGoogle Scholar
  21. 21.
    Ben Abdesselam O, Vally J, Adem C, Foglietti M-J, Beaudeux J-L. Reference values for serum S-100B protein depend on the race of individuals. Clin Chem. 2003;49(5):836–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Bouvier D, Duret T, Rouzaire P, Jabaudon M, Rouzaire M, Nourrisson C, et al. Preanalytical, analytical, gestational and pediatric aspects of the S100B immuno-assays. Clin Chem Lab Med. 2016;54(5):833–42.CrossRefPubMedGoogle Scholar
  23. 23.
    Beaudeux J, Dequen L, Foglietti M. Pathophysiologic aspects of S-100beta protein: a new biological marker of brain pathology [in French]. Ann Biol Clin (Paris). 1999;57(3):261–72.PubMedGoogle Scholar
  24. 24.
    Ray P, Le Manach Y, Riou B, Houle TT. Statistical evaluation of a biomarker. Anesthesiology. 2010;112(4):1023–40.CrossRefPubMedGoogle Scholar
  25. 25.
    Biberthaler P, Linsenmeier U, Pfeifer K-J, Kroetz M, Mussack T, Kanz K-G, et al. Serum S-100B concentration provides additional information fot the indication of computed tomography in patients after minor head injury: a prospective multicenter study. Shock. 2006;25(5):446–53.CrossRefPubMedGoogle Scholar
  26. 26.
    Pham N, Fazio V, Cucullo L, Teng Q, Biberthaler P, Bazarian JJ, et al. Extracranial sources of S100B do not affect serum levels. PloS One. 2010;5(9):e12691.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Marchi N, Bazarian JJ, Puvenna V, Janigro M, Ghosh C, Zhong J, et al. Consequences of repeated blood–brain barrier disruption in football players. PloS One. 2013;8(3):e56805.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Hasselblatt M, Mooren FC, von Ahsen N, Keyvani K, Fromme A, Schwarze-Eicker K, et al. Serum S100beta increases in marathon runners reflect extracranial release rather than glial damage. Neurology. 2004;62(9):1634–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Zetterberg H, Smith DH, Blennow K. Biomarkers of mild traumatic brain injury in cerebrospinal fluid and blood. Nat Rev Neurol. 2013;9(4):201–10.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Townend W, Dibble C, Abid K, Vail A, Sherwood R, Lecky F. Rapid elimination of protein S-100B from serum after minor head trauma. J Neurotrauma. 2006;23(2):149–55.CrossRefPubMedGoogle Scholar
  31. 31.
    Feise RJ. Do multiple outcome measures require p-value adjustment? BMC Med Res Methodol. 2002;2:8.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Damien Bouvier
    • 1
    • 2
  • Thomas Duret
    • 1
  • Mathieu Abbot
    • 3
    • 4
  • Thibault Stiernon
    • 3
  • Bruno Pereira
    • 5
  • Aurélien Coste
    • 6
  • Jean Chazal
    • 6
  • Vincent Sapin
    • 1
    • 2
    • 7
    • 8
    Email author
  1. 1.Department of Biochemistry and Molecular BiologyCHU Clermont-FerrandClermont-FerrandFrance
  2. 2.EA7281-Retinoids, Reproduction Developmental Diseases, School of MedicineClermont Université, Université d’AuvergneClermont-FerrandFrance
  3. 3.Medical DepartmentSports Association Montferrandaise Clermont Auvergne (ASMCA)Clermont-FerrandFrance
  4. 4.Department of Sport Medicine and Functional ExplorationsCHU Clermont-FerrandClermont-FerrandFrance
  5. 5.Department of Biostatistics Unit (DRCI)CHU Clermont-FerrandClermont-FerrandFrance
  6. 6.Department of NeurosurgeryCHU Clermont-FerrandClermont-FerrandFrance
  7. 7.Laboratoire de Biochimie Médicale, 4R3, Faculté de MédecineUniversité d’AuvergneClermont Ferrand CedexFrance
  8. 8.Observatoire Médical, FFR-LNRMarcoussisFrance

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