Background: To reduce the reliance on clinical judgment for the regulation of sports-related traumatic brain injury, identifying and measuring objective to biofluid biomarkers can provide important insight into the diagnosis (Determining the type and origin of a disorder) and prognosis (Determining the chance of survival of a disorder) of SR-TBIs. A biomarker is a qualitative or quantitative measurement that provides a measure of a subject’s physiological or pathological condition at a specific time or during a disease state. Recent literature has suggested that biomarkers can help in the screening of patients exhibiting symptoms of mild traumatic brain injury (mTBI). Despite insights from recent research, it is not clear whether biomarkers and assessments of sports-related TBI are well-aligned. The objective of this study sought to review the current literature on predictive values of biomarkers: glial fibrillary acidic protein (GFAP), calcium channel binding protein S100 subunit beta (S100β), total-tau and neuron-specific enolase (NSE) for sports-related Traumatic Brain Injuries (SR-TBIs) to improve comprehension of biological and clinical contexts that can help evaluate the use of these biomarkers in sports-related TBIs and their potential function.

Methods: The study was reported based on guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA: 2020 Edition) of 8 studies related to the assessment of biomarkers concerning SR-TBI. Literature searches were carried out on PubMed, Google Scholar, ScienceDirect, and ResearchGate. With an evidentiary table, the characteristics of the studies included in the meta-analysis (n = 14 studies) were presented. A significant role for biomarkers in the management of mild traumatic brain injury is suggested by the results of this analysis. From the literature, the significance of biomarkers in SR-TBI was identified along with the biomarkers that can facilitate more accurate clinical decision-making.

Results:The initial search resulted in 73 articles, and the application of exclusion criteria and removal of duplicates resulted in the inclusion of 14 articles. Eight of the included studies were ([26], [27], [28], [30], [34], [39], [40], [41]), three were cohort studies ([25], [37], [45]) one was a pilot study [32], one interview, and an observational study [44]. The review was carried out to determine the efficacy of Biomarkers GFAP, S100β, Total-tau, and NSE to help in the screening of mild traumatic brain injury (mTBI) in patients showing symptoms. The focus is on athletes presenting at an emergency department with possible mTBI requiring a CT scan based on the application of a clinical algorithm. A forest plot was utilized, and the studies had low heterogeneity or variability (P

Conclusions: It was established that the utility of biofluid biomarkers in the prediction of mild traumatic brain injury due to SRC is significant when the markers are used in large combinations. The four biofluid biomarkers (S100β, total-tau, GFAP, NSE) under study have strong predictive ability for mTBI, and their use can reduce the number of CT scans among TBI patients participating in athletic activities. Although preliminary evidence shows that other diagnostic treatments may help to mitigate traumatic brain injury sequelae, clinical trials are needed to further test their efficacy, specifically with diverse and high-risk populations. Luckily, the research on mTBI biomarkers is rapidly advancing, and should these biomarkers be better established clinically, they could easily hold many important roles.

Thesis Completion




Thesis Chair/Advisor

Dow, Tina


Bachelor of Arts (B.A.)


College of Medicine


Burnett School of Biomedical Sciences

Degree Program

Biomedical Sciences



Access Status

Open Access

Release Date