Neurobiomarker and body temperature responses to recreational marathon running

M.J. Stacey*, T. Leckie, D. Fitzpatrick, L. Hodgson, A. Barden, R. Jenkins, R. Galloway, C. Weller, G.V. Grivas, Y. Pitsiladis, A.J. Richardson, D.R. Woods

*Corresponding author for this work

    Research output: Contribution to journalJournal articlepeer-review


    Objectives: To assess how biomarkers indicating central nervous system insult (neurobiomarkers) vary in peripheral blood with exertional-heat stress from prolonged endurance exercise.

    Design: Observational study of changes in neuron specific enolase (NSE), S100 calcium-binding protein B (S100β), Glial Fibrillary Acid Protein (GFAP) and Ubiquitin carboxyl-terminal hydrolase isozyme L1 (UCHL1) at Brighton Marathon 2022.

    Methods: In 38 marathoners with in-race core temperature (Tc) monitoring, exposure (High, Intermediate or Low) was classified by cumulative hyperthermia – calculated as area under curve of Time × Tc > 38 °C – and also by running duration (finishing time). Blood was sampled for neurobiomarkers, cortisol and fluid-regulatory stress surrogates, including copeptin and creatinine (at rested baseline; within 30 min of finishing; and at 24 h).

    Results: Finishing in 236 ± 40 min, runners showed stable GFAP and UCH-L1 across the marathon and next-day. Significant (P < 0.05) increases from baseline were shown post-marathon and at 24 h for S100β (8.52 [3.65, 22.95] vs 39.0 [26.48, 52.33] vs 80.3 [49.1, 99.7] ng·L−1) and post-marathon only for NSE (3.73 [3.30, 4.32] vs 4.85 [4.45, 5.80] μg·L−1, P < 0.0001). Whilst differential response to hyperthermia was observed for cortisol, copeptin and creatinine, neurobiomarker responses did not vary. Post-marathon, only NSE differed by exercise duration (High vs Low, 5.81 ± 1.77 vs. 4.69 ± 0.73 μg·L−1, adjusted P = 0.0358).

    Conclusions: Successful marathon performance did not associate with evidence for substantial neuronal insult. To account for variation in neurobiomarkers with prolonged endurance exercise, factors additional to hyperthermia, such as exercise duration and intensity, should be further investigated.

    Original languageEnglish
    Pages (from-to)566-573
    Number of pages8
    JournalJournal of Science and Medicine in Sport
    Issue number11
    Publication statusPublished - Nov 2023

    Scopus Subject Areas

    • Orthopedics and Sports Medicine
    • Physical Therapy, Sports Therapy and Rehabilitation

    User-Defined Keywords

    • Brain injuries, traumatic
    • Copeptin
    • GFAP protein, human
    • Heat illness
    • Heat stroke
    • Ubiquitin carboxyl-terminal hydrolase L-1, human


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