Concussions are frequent in sports and can contribute to significant and long-lasting neurological disability. Adolescents are particularly susceptible to concussions, with accurate determination of the injury challenging. Our previous study demonstrated that concussion diagnoses could be aided by metabolomics profiling and machine learning, with particular weighting on changes in plasma glycerophospholipids (PCs). Here, our aim was to report directional change of PCs after concussion and develop a diagnostic concussion panel utilizing a minimum number of plasma PCs. To this end, we enrolled 12 concussed male athletes at our academic Sport Medicine Concussion Clinic, as well as 17 sex-, age-, and activity-matched healthy controls. Blood was drawn and 71 plasma PCs were measured for statistically significant changes within 72 h of injury, and individual PCs were further analyzed with receiver operating characteristic (ROC) curves. Our data demonstrated that 26 of 71 PCs measured were significantly decreased after sports-related concussion (p < 0.01). None of the PCs increased in plasma after concussion. ROC curve analyses identified the top four PCs with areas under the curve (AUCs) ≥0.86 for concussion diagnosis: PCaeC36:0 (0.92; p < 0.001); PCaaC42:6 (0.90; p < 0.001); PCaeC36:2 (0.86; p = 0.001), and PCaaC32:0 (0.86; p = 0.001). Cut-off values in μM were ≤0.31, 0.22, 5.07, and 4.63, respectively. Importantly, combining these four PCs produced an AUC of 0.96 for concussion diagnoses (p < 0.001; 95% confidence interval, 0.89, 1.00). Our data suggest that as few as four circulating PCs may provide excellent diagnostic potential for adolescent concussion. External validation is required in larger cohorts.

中文翻译：

---

脑震荡会急剧降低青少年男性运动员的血浆甘油磷脂

脑震荡在运动中很常见，并可能导致严重且长期的神经功能障碍。青少年特别容易受到脑震荡的影响，准确确定损伤具有挑战性。我们之前的研究表明，代谢组学分析和机器学习可以帮助脑震荡诊断，尤其重视血浆甘油磷脂 (PC) 的变化。在这里，我们的目标是报告脑震荡后 PC 的方向变化，并利用最少数量的等离子 PC 开发一个诊断脑震荡面板。为此，我们在我们的学术运动医学脑震荡诊所招募了 12 名脑震荡的男性运动员，以及 17 名性别、年龄和活动匹配的健康对照。在受伤后 72 小时内抽取血液并测量 71 个血浆 PC 的统计学显着变化，并使用受试者工作特征 (ROC) 曲线进一步分析单个 PC。我们的数据表明，在与运动相关的脑震荡后，测量的 71 台 PC 中有 26 台显着下降（p  < 0.01)。脑震荡后血浆中没有一个 PCs 增加。ROC 曲线分析确定了用于脑震荡诊断的曲线下面积 (AUC) ≥0.86 的前四位 PC：PCaeC36:0 (0.92; p  < 0.001)；PCaaC42:6 (0.90; p  < 0.001); PCaeC36:2 (0.86; p  = 0.001) 和 PCaaC32:0 (0.86; p  = 0.001)。μM 的截止值分别为 ≤0.31、0.22、5.07 和 4.63。重要的是，将这四台 PC 组合起来用于脑震荡诊断的 AUC 为 0.96（p  < 0.001；95% 置信区间，0.89，1.00）。我们的数据表明，只有四台循环 PC 可能为青少年脑震荡提供极好的诊断潜力。在较大的队列中需要外部验证。