Advisor(s)
José Fernández
Paula Chandler-Laney
Committee Member(s)
Douglas Moellering
Ian McKeag
Ryan Moran
School
School of Health Professions
Document Type
Dissertation
Department (new version)
Nutrition Sciences
Date of Award
9-11-2025
Abstract
Concussions represent a critical public health concern, affecting millions annually yet remain challenging to diagnose and manage. Concussions involve a range of often invisible signs and symptoms. Traditional assessments rely heavily on subjective symptom reporting, with limited objective data which may complicate return-to-play decisions. Objective physiological biomarkers are needed to complement traditional methods, detect subtle disruptions, and improve decision-making. Following concussion, the brain undergoes a neurometabolic cascade involving disrupted glucose utilization, ionic imbalances, neurotransmitter release, and reduced cerebral blood flow. This cascade creates a metabolic crisis, potentially shifting energy metabolism toward alternative substrates such as ketones. Breath acetone, a measurable non-invasive ketone, may serve as a biomarker of these metabolic changes. Given limitations of symptom-based assessments, breath acetone may represent an adjunctive biomarker by offering objective insight into concussion-induced metabolic alterations. However, breath acetone can be influenced by individual physiological factors like body composition, metabolic rate, or dietary habits. Once seen as a passive fat metabolism byproduct, acetone is now recognized for physiological roles, though its interaction with cofactors remains unclear. Understanding these sources of variability is essential to interpret post-concussion changes in breath acetone. This dissertation evaluated breath acetone's potential as a concussion biomarker through three interconnected aims: 1) assessing its relationship with body composition in healthy collegiate athletes; 2) comparing levels in concussed versus non-concussed athletes; and 3) examining relationships with symptom burden during acute recovery. Data were collected across two studies from Division I athletes using repeated breath sampling, bioelectrical impedance analysis, and daily symptom tracking through cross-sectional and longitudinal designs. Results demonstrated 1) no significant relationship between breath acetone and body composition, indicating independence from body composition; 2) significantly elevated breath acetone in concussed athletes within 14 days post-injury when compared controls and their own recovered levels, aligning with known neurometabolic and symptom resolution timelines; and 3) no symptom burden relationship, but daily symptom count fluctuations corresponded with breath acetone changes, suggesting complementary relationships between symptoms and metabolic state. These preliminary findings support continued exploration of breath acetone as a concussion biomarker through larger, more robust, clinical investigations.
ProQuest ID
Recommended Citation
Abadie, Allyn, "Breath Acetone As A Biomarker For Concussion" (2025). All ETDs from UAB. 7337.
https://digitalcommons.library.uab.edu/etd-collection/7337
