Effect of Docosahexaenoic Acid on a Biomarker of Head Trauma in American Football

Purpose 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. Methods 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 gd(-1) 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. Results DHA supplementation increased plasma DHA in a dose-dependent manner (2 gd(-1): mean difference from baseline; 90% CL; 2 gd(-1): 1.3; +/- 0.6; 4 gd(-1): 1.6; +/- 0.7%; 6 gd(-1): 2.8; +/- 1.2%). Serum NFL increased to a greater extent in starters (area under the curve, 1995 +/- 1383 pgmL(-1)) versus nonstarters (1398 +/- 581 pgmL(-1); 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). Conclusions 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.