A - 08 Investigating Associations of CMV Serostatus, Concussion History, and Clinical and Biomarker Outcomes in Collegiate Athletes

Abstract Purpose There is great interest in determining why adverse outcomes are observed in subsets of athletes with repeated concussions. Cytomegalovirus (CMV) is a common neurotropic virus that has shown to be reactivated due to stress or inflammation. We tested the hypothesis that CMV serostatus moderates the relationship of concussion history with clinical measures and blood-based biomarkers of inflammation and brain injury. Method Collegiate athletes (N = 208; 62.5% male, mean age 20.99 ± 1.68 years) with varying concussion histories were enrolled. Blood samples were analyzed for IgG CMV antibodies using ELISA. Clinical outcomes included concussion-related symptoms, psychological symptoms, and depression and anxiety symptoms. Concentrations of IL-1RA, IL-6, IL-10, CRP, TNF, GFAP, tau, and NFL were measured in serum. General linear models examined the interaction of CMV serostatus with prior concussion history on clinical outcomes and blood-based biomarkers. Results 27.4% of the athletes tested positive for CMV antibodies. CMV+ athletes were older and more likely to be non-white (ps < 0.05). There was a significant interaction of CMV serostatus and number of prior concussions for levels of IL-6, with a positive association between IL-6 and prior concussions observed in CMV+ athletes (B(SE) = 0.259(0.08), p = 0.001) but not CMV- athletes (B(SE) = 0.022(0.05), p = 0.665). Concussion history was associated with increased symptoms across all clinical measures, irrespective of CMV status (ps < 0.05). Conclusions CMV serostatus moderates the relationship between prior concussions and IL-6 levels, highlighting its role in exacerbating immune responses to repeated head injuries. Concussion history remains associated with increased symptoms regardless of CMV status.