title: Effect of Docosahexaenoic Acid on a Biomarker of Head Trauma in American Football.
abstract: American football athletes are exposed to subconcussive impacts over the course of the season resulting in elevations in serum neurofilament light (NFL), a biomarker of axonal injury. Docosahexaenoic acid (DHA) has been reported to reduce axonal trauma associated with traumatic brain injury in rodent models. However, the optimal dose in American football athletes is unknown. This study examined the effect of differing doses of DHA on serum NFL over the course of a season of American football.
  
  
  
  In a randomized, double-blind, placebo-controlled, parallel design, 81 National Collegiate Athletic Association Division I American football athletes were assigned to ingest either 2, 4, 6 g·d of DHA or placebo. Blood was sampled at specific times over the course of 189 d, coincident with changes in intensity, hours of contact, and likely changes in head impacts. Standardized magnitude-based inference was used to define outcomes.
  
  
  
  DHA supplementation increased plasma DHA in a dose-dependent manner (2 g·d: mean difference from baseline; ±90% CL; 2 g·d: 1.3; ±0.6; 4 g·d: 1.6; ±0.7%; 6 g·d: 2.8; ±1.2%). Serum NFL increased to a greater extent in starters (area under the curve, 1995 ± 1383 pg·mL) versus nonstarters (1398 ± 581 pg·mL; P = 0.024). Irrespective of dose, supplemental DHA likely attenuated serum NFL coincident with increases in serum NFL by likely small and moderate magnitude (effect size = 0.4-0.7).
  
  
  
  Findings from this study, the first large-scale study examining potential prophylactic use of DHA in American football athletes, include identification of optimal dose of DHA, suggesting a neuroprotective effect of DHA supplementation.
authors.affiliation: 1Sports Concussion Research Group, Department of Kinesiology, Texas Christian University, Fort Worth, TX; 2Division of Health and Human Performance, George Mason University, Manassas, VA; 3Department of Sport Medicine, Texas Christian University, Fort Worth, TX; 4Department of Sport Medicine, John Peter Smith Hospital, Fort Worth, TX; 5UmanDiagnostics, Umeå, SWEDEN; 6Clinical Neurochemistry Laboratory, Institute Of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Mölndal, SWEDEN; and 7Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UNITED KINGDOM.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Oliver
authors.forename: Margaret T
authors.initials: MT
authors.lastname: Jones
authors.forename: K Michele
authors.initials: KM
authors.lastname: Kirk
authors.forename: David A
authors.initials: DA
authors.lastname: Gable
authors.forename: Justin T
authors.initials: JT
authors.lastname: Repshas
authors.forename: Torie A
authors.initials: TA
authors.lastname: Johnson
authors.forename: Ulf
authors.initials: U
authors.lastname: Andréasson
authors.forename: Niklas
authors.initials: N
authors.lastname: Norgren
authors.forename: Kaj
authors.initials: K
authors.lastname: Blennow
authors.forename: Henrik
authors.initials: H
authors.lastname: Zetterberg
mesh_terms: D015415:Biomarkers / Q000097:blood*; D001924:Brain Concussion / Q000097:blood* / Q000517:prevention & control; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage* / Q000097:blood; D004311:Double-Blind Method; D005538:Football / Q000293:injuries*; D006801:Humans; D016900:Neurofilament Proteins / Q000097:blood*
chemical_list: D015415:Biomarkers; D016900:Neurofilament Proteins; C044882:neurofilament protein L; D004281:Docosahexaenoic Acids