Should an increase in cerebral neurochemicals following head kicks in full contact karate influence return to play?

M R Graham; J Pates; B Davies; S M Cooper; K Bhattacharya; P J Evans; J S Baker

doi:10.1177/0394632015577045

Should an increase in cerebral neurochemicals following head kicks in full contact karate influence return to play?

Int J Immunopathol Pharmacol. 2015 Dec;28(4):539-46. doi: 10.1177/0394632015577045. Epub 2015 Mar 26.

Authors

M R Graham¹, J Pates¹, B Davies², S M Cooper³, K Bhattacharya⁴, P J Evans⁵, J S Baker⁶

Affiliations

¹ Llantarnam Research Academy, Newport Road, Llantarnam, Cwmbran, Wales, UK.
² Health and Exercise Science Department, University of South Wales, Cardiff, Wales, UK.
³ Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, Wales, UK.
⁴ Department of Cardiovascular Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK Deceased.
⁵ Department of Endocrinology, Royal Gwent Hospital, Newport, Wales, UK.
⁶ Institute of Clinical Exercise and Health Science, Applied Physiology Research Laboratory, School of Science and Sport, University of the West of Scotland, Hamilton, Scotland, UK jsbaker@uws.ac.uk.

PMID: 25816397
DOI: 10.1177/0394632015577045

Abstract

Background: Cerebral neurochemicals are markers of traumatic brain injury (TBI).

Objectives: The aim of the study was to determine whether kicks to the head (KTH) in full contact karate significantly increased serum concentrations of protein S-100B, and neurone specific enolase (NSE). Kicks to the body (KTB) were also quantified to asses muscle tissue injury. Muscle damage was assessed by analysis of serum total creatine kinase (CK).

Methods: Twenty-four full contact karate practitioners were observed and filmed during actual competition and divided into two main groups post event: (1) Kicks to the head and body group (KTH): n = 12; mean ± SD; age, 30.4 ± 6.7 years; height, 1.74 ± 0.1 m; weight, 79.1 ± 2.1 kg; and (2): Kicks to the body group (KTB): n = 12; mean ± SD; age, 28.2 ± 6.5 years; height, 1.75 ± 0.1 m; weight, 79.2 ± 1.7 kg. The KTH group received direct kicks to the head, while group KTB received kicks and punches to the body. Blood samples were taken before and immediately post-combat for analysis of serum S-100B, NSE, CK and cardiac troponin.

Results: Significant increases in serum concentrations of S-100B (0.12 ± 0.17 vs. 0.37 ± 0.26, µg.L(-1)) and NSE (11.8 ± 4.1 vs. 20.2 ± 9.1 ng.mL(-1)) were encountered after combat in the KTH group and CK (123 ± 53 vs. 184 ± 103 U.L(-1)) in the KTB group (all P <0.05).

Conclusions: Head kicks in full contact karate cause elevation of neurochemical markers associated with damaged brain tissue. The severity of injury is related to the early post-traumatic release of protein S-100B and NSE. The early kinetics and appearance post injury can reflect intracranial pathology, and suggest S-100B and NSE are extremely sensitive prognostic markers of TBI.

Keywords: NSE; S100-B; TBI; concussion; sport.

MeSH terms

Adult
Brain Injuries / blood*
Creatine Kinase / blood
Humans
Martial Arts*
Phosphopyruvate Hydratase / blood*
Return to Sport*
S100 Calcium Binding Protein beta Subunit / blood*

Substances

S100 Calcium Binding Protein beta Subunit
Creatine Kinase
Phosphopyruvate Hydratase