Exploratory analysis of plasma pTau181 and frontal EEG in young male rugby players with cumulative sport-related concussions.

OBJECTIVES

Sport-related concussion (SRC) is a common injury in rugby and has been implicated in long-term neurodegenerative risks. However, early indicators of neurophysiological and molecular changes in active athletes remain poorly defined. Therefore, this study aims to investigate the association between cumulative SRC exposure and biomarkers of early neurodegeneration in rugby athletes.

DESIGN

Cross-sectional design.

METHODS

Thirty elite collegiate and semi-professional male rugby players (21.13 ± 2.71 years) underwent ultrasensitive plasma-based biomarkers (amyloid-β40, amyloid-β42, total tau, and phosphorylated-tau-181 [pTau181]), frontal Electroencephalography (EEG) during rest and cognitive tasks (Stroop and King-Devick tests), and Sport Concussion Assessment Tool, 6th edition (SCAT6). SRC history was verified using team medical records and SCAT6. Pearson's and Partial correlation (covariates: age, career duration, playing position, and time since last SRC) analyses were conducted.

RESULTS

SRC history was significantly associated with pTau181 level (r = 0.398, p = 0.044), while other biomarkers showed no significant relationship. EEG analyses revealed that SRC count correlated with increased delta and gamma power during eyes-closed, and decreased frontal gamma power during eyes-open rest and the Stroop task. Additionally, pTau181 levels correlated with altered frontal EEG patterns during Stroop task. Cognitive performance was largely preserved, with only Stroop accuracy showing significant decline with SRC history.

CONCLUSIONS

Young male rugby players with greater SRC exposure exhibited a trend toward elevated plasma pTau181 level and exploratory indications of altered frontal EEG activity. Further studies with larger samples and longitudinal designs are warranted to confirm the potential utility of peripheral and electrophysiological biomarkers for early risk monitoring in contact-sport athletes.