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Chizuk, Haley State University of New York at Buffalo ProQuest D 2023 해외박사(DDOD)
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Concussion, a subtype of mild traumatic brain injury (mTBI), is caused by a sudden blow to the head or body that transmits force to the brain triggering a pathophysiological cerebral metabolic response in the absence of gross structural changes. Previous research has shown that prescribed aerobic exercise speeds recovery from concussion and reduces the incidence of prolonged symptoms. One theory to explain the mechanism of recovery from concussion is that aerobic exercise improves the production of Brain-Derived Neurotrophic Factor (BDNF), a protein that plays a role in neuronal healing. Epigenetic regulators, such as microRNA (miRNAs), may reveal other mechanisms by which concussion recovery occurs. This study examines the relationship between prescribed aerobic exercise and salivary BDNF/miRNA expression in acutely concussed adolescents throughout recovery. Eligible participants completed clinical examinations and provided saliva samples throughout a two-week intervention. Participants were randomly assigned high or low exercise volumes to assess the effect of exercise dose. This intervention follows the American College of Sports Medicine’s exercise guidelines and the current standard of care. Our data show that acutely concussed females have higher salivary BDNF levels than female controls, initially and over time. Concussed and healthy males had similar BDNF concentrations, initially and over time. Additionally, increasing exercise intensity may play a role in increasing BDNF expression. Of the 12 miRNAs assessed, we found one miRNA, 7-1-3p, that changed over time, one miRNA, 182-5p, affected by exercise volume, and one miRNA, 30e-3p, changed over time and was affected by concussion and sex. Salivary BDNF and miRNA have the potential to act as objective biomarkers to increase clinician confidence when determining recovery to improve patient outcomes.