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Tegner, Yelverton, Professor emeritusORCID iD iconorcid.org/0000-0003-3628-0705
Publications (10 of 264) Show all publications
Gard, A., Vedung, F., Piehl, F., Khademi, M., Wernersson, M. P., Rorsman, I., . . . Marklund, N. (2023). Cerebrospinal fluid levels of neuroinflammatory biomarkers are increased in athletes with persistent post-concussive symptoms following sports-related concussion. Journal of Neuroinflammation, 20, Article ID 189.
Open this publication in new window or tab >>Cerebrospinal fluid levels of neuroinflammatory biomarkers are increased in athletes with persistent post-concussive symptoms following sports-related concussion
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2023 (English)In: Journal of Neuroinflammation, ISSN 1742-2094, E-ISSN 1742-2094, Vol. 20, article id 189Article in journal (Refereed) Published
Abstract [en]

A sports-related concussion (SRC) is often caused by rapid head rotation at impact, leading to shearing and stretching of axons in the white matter and initiation of secondary inflammatory processes that may exacerbate the initial injury. We hypothesized that athletes with persistent post-concussive symptoms (PPCS) display signs of ongoing neuroinflammation, as reflected by altered profiles of cerebrospinal fluid (CSF) biomarkers, in turn relating to symptom severity. We recruited athletes with PPCS preventing sports participation as well as limiting work, school and/or social activities for ≥ 6 months for symptom rating using the Sport Concussion Assessment Tool, version 5 (SCAT-5) and for cognitive assessment using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Following a spinal tap, we analysed 27 CSF inflammatory biomarkers (pro-inflammatory chemokines and cytokine panels) by a multiplex immunoassay using antibodies as electrochemiluminescent labels to quantify concentrations in PPCS athletes, and in healthy age- and sex-matched controls exercising ≤ 2 times/week at low-to-moderate intensity. Thirty-six subjects were included, 24 athletes with PPCS and 12 controls. The SRC athletes had sustained a median of five concussions, the most recent at a median of 17 months prior to the investigation. CSF cytokines and chemokines levels were significantly increased in eight (IL-2, TNF-α, IL-15, TNF-β, VEGF, Eotaxin, IP-10, and TARC), significantly decreased in one (Eotaxin-3), and unaltered in 16 in SRC athletes when compared to controls, and two were un-detectable. The SRC athletes reported many and severe post-concussive symptoms on SCAT5, and 10 out of 24 athletes performed in the impaired range (Z < − 1.5) on cognitive testing. Individual biomarker concentrations did not strongly correlate with symptom rating or cognitive function. Limitations include evaluation at a single post-injury time point in relatively small cohorts, and no control group of concussed athletes without persisting symptoms was included. Based on CSF inflammatory marker profiling we find signs of ongoing neuroinflammation persisting months to years after the last SRC in athletes with persistent post-concussive symptoms. Since an ongoing inflammatory response may exacerbate the brain injury these results encourage studies of treatments targeting the post-injury inflammatory response in sports-related concussion.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Biomarkers, Cerebrospinal fluid, Chemokines, Concussion, Cytokines, Neuroinflammation, Persisting post-concussive symptoms, Sport
National Category
Neurology Sport and Fitness Sciences Neurosciences
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-101225 (URN)10.1186/s12974-023-02864-0 (DOI)001050470900001 ()37592277 (PubMedID)2-s2.0-85168496404 (Scopus ID)
Funder
Swedish Research CouncilSwedish National Centre for Research in SportsThe Swedish Brain Foundation, KR FO2020-0138, FO2022-0154
Note

Validerad;2023;Nivå 2;2023-09-06 (hanlid);

Funder: Hans-Gustaf af Trolle-Wachtmeister Foundation (HGATW); Alborada Trust; ALF 

Available from: 2023-09-06 Created: 2023-09-06 Last updated: 2023-09-06Bibliographically approved
Napoli, R., Fortina, M., Plebani, G., Giannotti, S., Pannone, A., Rossi, A., . . . Vascellari, A. (2023). Cross Cultural Adaptation and Multi Centric Validation of The Italian Version of The Tegner Activity Scale. Muscles, Ligaments and Tendons Journal, 13(1), 156-162
Open this publication in new window or tab >>Cross Cultural Adaptation and Multi Centric Validation of The Italian Version of The Tegner Activity Scale
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2023 (English)In: Muscles, Ligaments and Tendons Journal, E-ISSN 2240-4554, Vol. 13, no 1, p. 156-162Article in journal (Refereed) Published
Abstract [en]

Background. This study aims to adapt the Tegner Activity Scale (TAS) to Italian language and establish its reliability and validity in patients after anterior cruciate ligament reconstruction. It was hypnotized the Italian version of the TAS have acceptable psychometric properties for use with the Italian population.

Methods. This is an observational multicenter study. The Tegner Activity Scale was translated and culturally adapted according to the Beaton guidelines. A web-based survey was conducted to evaluate the construct validity: 62 patients were included in the study. Spearman’s rank correlation coefficient (r) between the TAS and the Short Form 36 (SF-36) subscales and the International Knee Documentation Committee (IKDC) was used to evaluate construct validity. The patients completed the TAS again one week after their first submission, and the intraclass correlation coefficient was used to calculate the test-retest reliability.

Results. The correlation coefficient showed moderate correlation with the SF-36 Physical Function domain (r = 0.41; p = 0.001) and weak correlation with the IKDC (r = 0.3; p = 0.02). Correlations with the other SF-36 subscales were very weak and not statistically significant. Test-retest reliability (0.68, 95%CI 0.43-0.83) ranged from good to excellent.

Conclusions. The Italian version of the Tegner Activity Scale is a valid instrument to assess a patient’s level of sporting activity after anterior cruciate ligament reconstruction. Cultural adaptation of this scale is fundamental to make this instrument comparable throughout scientific literature.

Place, publisher, year, edition, pages
EDRA S.p.A, 2023
Keywords
ACL injury, Anterior cruciate ligament reconstruction, functional score, knee function, patient-centered care, PROMs, rehabilitation, reliability, return to sport
National Category
Physiotherapy Orthopaedics
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-96616 (URN)10.32098/mltj.01.2023.18 (DOI)2-s2.0-85150971126 (Scopus ID)
Note

Validerad;2023;Nivå 2;2023-04-18 (hanlid)

Available from: 2023-04-18 Created: 2023-04-18 Last updated: 2023-04-18Bibliographically approved
Adhitya, I. P., Wibawa, A., Aryana, I. G. & Tegner, Y. (2023). Reliability, validity, and responsiveness of the Indonesian version of the Lysholm knee score and Tegner activity scale in patients with anterior cruciate ligament reconstruction. Journal of Bodywork & Movement Therapies, 34, 53-59
Open this publication in new window or tab >>Reliability, validity, and responsiveness of the Indonesian version of the Lysholm knee score and Tegner activity scale in patients with anterior cruciate ligament reconstruction
2023 (English)In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 34, p. 53-59Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2023
National Category
Physiotherapy
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-97050 (URN)10.1016/j.jbmt.2023.04.062 (DOI)2-s2.0-85153219842 (Scopus ID)
Note

Validerad;2023;Nivå 2;2023-05-10 (hanlid);

Funder: College of Medicine, Universitas Udayana, Bali, Indonesia (B/78.328/UN14.4.A/PT.01.03/2022)

Available from: 2023-05-10 Created: 2023-05-10 Last updated: 2023-05-10Bibliographically approved
Al-Husseini, A., Fazel Bakhsheshi, M., Gard, A., Tegner, Y. & Marklund, N. (2023). Shorter Recovery Time in Concussed Elite Ice Hockey Players by Early Head-and-Neck Cooling: A Clinical Trial. Journal of Neurotrauma, 40(11-12), 1075-1085
Open this publication in new window or tab >>Shorter Recovery Time in Concussed Elite Ice Hockey Players by Early Head-and-Neck Cooling: A Clinical Trial
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2023 (English)In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 40, no 11-12, p. 1075-1085Article in journal (Refereed) Published
Abstract [en]

A sports-related concussion (SRC) is most commonly sustained in contact sports, and is defined as a mild traumatic brain injury. An exercise-induced elevation of core body temperature is associated with increased brain temperature that may accelerate secondary injury processes following SRC, and exacerbate the brain injury. In a recent pilot study, acute head-neck cooling of 29 concussed ice hockey players resulted in shorter time to return-to-play. Here, we extended the clinical trial to include players of 19 male elite Swedish ice hockey teams over five seasons (2016-2021). In the intervention teams, acute head-neck cooling was implemented using a head cap for ≥45 min in addition to the standard SRC management used in controls. The primary endpoint was time from SRC until return-to-play (RTP). Sixty-one SRCs were included in the intervention group and 71 SRCs in the control group. The number of previous SRCs was 2 (median and interquartile range [IQR]: 1.0-2.0) and 1 (IQR 1.0-2.0) in the intervention and control groups, respectively; p = 0.293. Median time to initiate head-neck cooling was 10 min (IQR 7-15; range 5-30 min) and median duration of cooling was 45 min (IQR 45-50; range 45-70 min). The median time to RTP was 9 days in the intervention group (IQR 7.0-13.5 days) and 13 days in the control group (IQR 9-30; p < 0.001). The proportion of players out from play for more than the expected recovery time of 14 days was 24.7% in the intervention group, and 43.7% in controls (p < 0.05). Study limitations include that: 1) allocation to cooling or control management was at the discretion of the medical staff of each team, decided prior to each season, and not by strict randomization; 2) no sham cap was used and evaluations could not be performed by blinded assessors; and 3) it could not be established with certainty that injury severity was similar between groups. While the results should thus be interpreted with caution, early head-neck cooling, with the aim of attenuating cerebral hyperthermia, may reduce post-SRC symptoms and lead to earlier return-to-play in elite ice hockey players.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2023
Keywords
clinical trial, cooling, ice hockey, return-to-play, sport related concussion
National Category
Sport and Fitness Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-94099 (URN)10.1089/neu.2022.0248 (DOI)000883682200001 ()36222612 (PubMedID)2-s2.0-85160967232 (Scopus ID)
Funder
VinnovaSwedish National Centre for Research in Sports, 2020-0116The Swedish Brain Foundation, 2020Region Skåne
Note

Validerad;2023;Nivå 2;2023-07-13 (sofila);

Available from: 2022-11-14 Created: 2022-11-14 Last updated: 2023-10-11Bibliographically approved
Itthipanichpong, T., Moonwong, S., Thamrongskulsiri, N., Prasathaporn, N., Kuptniratsaikul, S., Tegner, Y., . . . Tanpowpong, T. (2023). Validity and Reliability of the Thai Versions of the Lysholm Knee Scoring Scale and Tegner Activity Scale. The Orthopaedic Journal of Sports Medicine, 11(2)
Open this publication in new window or tab >>Validity and Reliability of the Thai Versions of the Lysholm Knee Scoring Scale and Tegner Activity Scale
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2023 (English)In: The Orthopaedic Journal of Sports Medicine, ISSN 2325-9671, Vol. 11, no 2Article in journal (Refereed) Published
Abstract [en]

Background: Functional or quality of life questionnaires are important tools in clinical investigations. The Lysholm Knee Scoring Scale and Tegner Activity Scale are knee-specific questionnaires that are widely used to assess knee function.

Purpose: To translate both questionnaires into Thai and to assess the validity and reliability of the Thai versions of the Lysholm and adjusted Tegner scales.

Study Design: Cohort study (diagnosis); Level of evidence, 3.

Methods: The Lysholm and Tegner scales were translated into Thai by using the forward-backward translation protocol. Because cultural modifications were made to the sports used to measure activity on the Tegner scale, the authors of this study refer to the Thai version as the “Thai adjusted Tegner scale.” The reliability and validity of the translated scales were evaluated by obtaining the responses of 60 consecutive patients (mean age, 40.5 years; 34 male, 26 female); the patients also completed the Thai version of the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). Criterion validity was tested by correlating the scores from both translated questionnaires with those from the Thai IKDC-SKF, while reliability was assessed by measuring test-retest reliability and internal consistency.

Results: The Thai Lysholm scale showed a strong correlation with the Thai IKDC-SKF (r = 0.89), while the Thai adjusted Tegner scale showed a moderate correlation with the Thai IKDC-SKF (r = 0.60). The intrarater and test-retest reliability measures were excellent for the Thai Lysholm (intraclass correlation coefficient [ICC], 0.94 and 0.98, respectively) and moderate to good for the Thai adjusted Tegner (ICC, 0.73 and 0.86, respectively). The internal consistency for the Thai Lysholm was acceptable at all the time points (Cronbach alpha, 0.71-0.73).

Conclusion: The Thai Lysholm and Thai adjusted Tegner scales adequately retained the characteristics of the original versions. They can be considered reliable instruments for Thai patients with knee-related problems.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Lysholm Knee Scoring Scale, Tegner Activity Scale, validity, International Knee Documentation, Committee Subjective Knee Form, reliability, questionnaire
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-95882 (URN)10.1177/23259671221149785 (DOI)2-s2.0-85148328731 (Scopus ID)
Note

Validerad;2023;Nivå 2;2023-03-15 (joosat);

Licens fulltext: CC BY-NC-ND License

Available from: 2023-03-15 Created: 2023-03-15 Last updated: 2023-05-08Bibliographically approved
Shahim, P., Zetterberg, H., Simren, J., Ashton, N. J., Norato, G., Schöll, M., . . . Blennow, K. (2022). Association of Plasma Biomarker Levels With Their CSF Concentration and the Number and Severity of Concussions in Professional Athletes. Neurology, 99(4), e347-e354
Open this publication in new window or tab >>Association of Plasma Biomarker Levels With Their CSF Concentration and the Number and Severity of Concussions in Professional Athletes
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2022 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 99, no 4, p. e347-e354Article in journal (Refereed) Published
Abstract [en]

Objective: To examine whether the brain biomarkers total-tau (T-tau), glial fibrillary acidic protein (GFAP), and β-amyloid (Aβ) isomers 40 and 42 in plasma relate to the corresponding concentrations in cerebrospinal fluid (CSF), blood-brain barrier integrity, and duration of post-concussion syndrome (PCS) due to repetitive head impacts (RHI) in professional athletes.

Method: In this cross-sectional study, professional athletes with persistent PCS due to RHI (median of 1.5 years after recent concussion) and uninjured controls were assessed with blood and CSF sampling. The diagnosis of PCS was based on the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). The athletes were enrolled through information flyers about the study sent to the Swedish hockey league (SHL) and the SHL Medicine Committee. The controls were enrolled through flyers at University of Gothenburg and Sahlgrenska University Hospital, Sweden. The participants underwent lumbar puncture and blood assessment at Sahlgrenska University Hospital. The main outcome measures were history of RHI and PCS severity (PCS> 1 year versus PCS< 1 year) in relation to plasma and CSF concentrations of T-tau, GFAP, Aβ40, and Aβ42. Plasma T-tau, GFAP, Aβ40, and Aβ42 were quantified using an ultrasensitive assay technology.

Results: A total of 47 participants (28 athletes [median age 28 years, range 18-52] with persistent PCS, due to RHI and 19 controls [median age, 25 years, range 21-35]) underwent paired blood and cerebrospinal fluid (CSF) sampling. T-tau, Aβ40 and Aβ42 concentrations measured in plasma did not correlate with the corresponding CSF concentrations, while there was a correlation between plasma and CSF levels of GFAP (r=0.45, p=0.020). There were no significant relationships between plasma T-tau, GFAP, and blood-brain barrier integrity as measured by CSF:serum albumin ratio. T-tau, GFAP, Aβ40, and Aβ42 measured in plasma did not relate to PCS severity. None of the markers measured in plasma correlated with number of concussions, except decreased Aβ42 in those with higher number of concussions (r=–0.40, p=0.04).

Conclusions: T-tau, GFAP, Aβ40 and Aβ42 measured in plasma do not correspond to CSF measures, and may have limited utility for the evaluation of the late effects of RHI, compared with when measured in CSF.

Place, publisher, year, edition, pages
Wolters Kluwer, 2022
National Category
Neurology
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-91039 (URN)10.1212/wnl.0000000000200615 (DOI)000841844300014 ()35654597 (PubMedID)2-s2.0-85135282576 (Scopus ID)
Note

Validerad;2022;Nivå 2;2022-08-18 (hanlid)

Available from: 2022-06-07 Created: 2022-06-07 Last updated: 2022-12-05Bibliographically approved
Vedung, F., Fahlström, M., Wall, A., Antoni, G., Lubberink, M., Johansson, J., . . . Marklund, N. (2022). Chronic cerebral blood flow alterations in traumatic brain injury and sports-related concussions. Brain Injury
Open this publication in new window or tab >>Chronic cerebral blood flow alterations in traumatic brain injury and sports-related concussions
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2022 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301XArticle in journal (Refereed) Published
Abstract [en]

Primary Objective

Traumatic brain injury (TBI) and sports-related concussion (SRC) may result in chronic functional and neuroanatomical changes. We tested the hypothesis that neuroimaging findings (cerebral blood flow (CBF), cortical thickness, and 1H-magnetic resonance (MR) spectroscopy (MRS)) were associated to cognitive function, TBI severity, and sex.

Research Design

Eleven controls, 12 athletes symptomatic following ≥3SRCs and 6 patients with moderate-severe TBI underwent MR scanning for evaluation of cortical thickness, brain metabolites (MRS), and CBF using pseudo-continuous arterial spin labeling (ASL). Cognitive screening was performed using the RBANS cognitive test battery.

Main Outcomes and Results

RBANS-index was impaired in both injury groups and correlated with the injury severity, although not with any neuroimaging parameter. Cortical thickness correlated with injury severity (p = 0.02), while neuronal density, using the MRS marker ((NAA+NAAG)/Cr, did not. On multivariate analysis, injury severity (p = 0.0003) and sex (p = 0.002) were associated with CBF. Patients with TBI had decreased gray (p = 0.02) and white matter (p = 0.02) CBF compared to controls. CBF was significantly lower in total gray, white matter and in 16 of the 20 gray matter brain regions in female but not male athletes when compared to female and male controls, respectively.

Conclusions

Injury severity correlated with CBF, cognitive function, and cortical thickness. CBF also correlated with sex and was reduced in female, not male, athletes. Chronic CBF changes may contribute to the persistent injury mechanisms in TBI and rSRC.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2022
Keywords
Arterial spin labeling (ASL), cerebral blood flow, magnetic resonance spectroscopy (MRS), Sports-related concussion, traumatic brain injury
National Category
Neurology Medical Engineering
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-92554 (URN)10.1080/02699052.2022.2109746 (DOI)000839563600001 ()35950271 (PubMedID)2-s2.0-85136914490 (Scopus ID)
Funder
The Swedish Brain Foundation, FO2021-0421Swedish Research Council, 2018-02500Swedish National Centre for Research in Sports, 2020-0116
Note

Validerad;2022;Nivå 2;2022-09-05 (hanlid)

Available from: 2022-08-18 Created: 2022-08-18 Last updated: 2022-09-12Bibliographically approved
Al-Husseini, A., Gard, A., Fransson, P.-A., Tegner, Y., Magnusson, M., Marklund, N. & Tjernström, F. (2022). Long-term postural control in elite athletes following mild traumatic brain injury. Frontiers in Neurology, 13, Article ID 906594.
Open this publication in new window or tab >>Long-term postural control in elite athletes following mild traumatic brain injury
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2022 (English)In: Frontiers in Neurology, E-ISSN 1664-2295, Vol. 13, article id 906594Article in journal (Refereed) Published
Abstract [en]

Background: Traumas to the head and neck are common in sports and often affects otherwise healthy young individuals. Sports-related concussions (SRC), defined as a mild traumatic brain injury (mTBI), may inflict persistent neck and shoulder pain, and headache, but also more complex symptoms, such as imbalance, dizziness, and visual disturbances. These more complex symptoms are difficult to identify with standard health care diagnostic procedures.

Objective: To investigate postural control in a group of former elite athletes with persistent post-concussive symptoms (PPCS) at least 6 months after the incident.

Method: Postural control was examined using posturography during quiet stance and randomized balance perturbations with eyes open and eyes closed. Randomized balance perturbations were used to examine motor learning through sensorimotor adaptation. Force platform recordings were converted to reflect the energy used to maintain balance and spectrally categorized into total energy used, energy used for smooth corrective changes of posture (i.e., <0.1 Hz), and energy used for fast corrective movements to maintain balance (i.e., >0.1 Hz).

Results: The mTBI group included 20 (13 males, mean age 26.6 years) elite athletes with PPCS and the control group included 12 athletes (9 males, mean age 26.4 years) with no history of SRC. The mTBI group used significantly more energy during balance perturbations than controls: +143% total energy, p = 0.004; +122% low frequency energy, p = 0.007; and +162% high frequency energy, p = 0.004. The mTBI subjects also adapted less to the balance perturbations than controls in total (18% mTBI vs. 37% controls, p = 0.042), low frequency (24% mTBI vs. 42% controls, p = 0.046), and high frequency (6% mTBI vs. 28% controls, p = 0.040). The mTBI subjects used significantly more energy during quiet stance than controls: +128% total energy, p = 0.034; +136% low-frequency energy, p = 0.048; and +109% high-frequency energy, p = 0.015.

Conclusion: Athletes with previous mTBI and PPCS used more energy to stand compared to controls during balance perturbations and quiet stance and had diminished sensorimotor adaptation. Sports-related concussions are able to affect postural control and motor learning.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
Keywords
mild traumatic brain injury, postural control, sports-related concussion, adaptation, vision, persisting post-concussive symptoms
National Category
Neurology Physiology
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-93476 (URN)10.3389/fneur.2022.906594 (DOI)000860576000001 ()36172026 (PubMedID)2-s2.0-85138758988 (Scopus ID)
Funder
Swedish National Centre for Research in Sports, CIF 2021-0105The Swedish Brain FoundationSwedish Research Council, VR 2018-02500
Note

Validerad;2022;Nivå 2;2022-10-05 (joosat);

Funder: Hospital ALF funds

Available from: 2022-10-05 Created: 2022-10-05 Last updated: 2023-08-28Bibliographically approved
Gard, A., Al-Husseini, A., Kornaropoulos, E. N., De Maio, A., Tegner, Y., Björkman-Burtscher, I., . . . Marklund, N. (2022). Post-Concussive Vestibular Dysfunction Is Related to Injury to the Inferior Vestibular Nerve. Journal of Neurotrauma, 39(11-12), 829-840
Open this publication in new window or tab >>Post-Concussive Vestibular Dysfunction Is Related to Injury to the Inferior Vestibular Nerve
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2022 (English)In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 39, no 11-12, p. 829-840Article in journal (Refereed) Published
Abstract [en]

Symptoms of vestibular dysfunction such as dizziness and vertigo are common after sports-related concussions (SRC) and associated with a worse outcome and a prolonged recovery. Vestibular dysfunction after SRC can be because of an impairment of the peripheral or central neural parts of the vestibular system. The aim of the present study was to establish the cause of vestibular impairment in athletes with SRC who have persisting post-concussive symptoms (PPCS). We recruited 42 participants—21 athletes with previous SRCs and PPCS ≥6 months and 21 healthy athletic age- and sex-matched controls—who underwent symptom rating, a detailed test battery of vestibular function and 7T magnetic resonance imaging with diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) of cerebellar white matter tracts, and T1-weighted imaging for cerebellar volumetrics. Vestibular dysfunction was observed in 13 SRC athletes and three controls (p = 0.001). Athletes with vestibular dysfunction reported more pronounced symptoms on the Dizziness Handicap Inventory (DHI; p < 0.001) and the Hospital Anxiety and Depression Scale (HADS; p < 0.001). No significant differences in DTI metrics were found, while in DKI two metrics were observed in the superior and/or inferior cerebellar tracts. Cerebellar gray and white matter volumes were similar in athletes with SRC and controls. Compared with controls, pathological video head impulse test results (vHIT; p < 0.001) and cervical vestibular evoked myogenic potentials (cVEMP; p = 0.002) were observed in athletes with SRC, indicating peripheral vestibular dysfunction and specifically suggesting injury to the inferior vestibular nerve. In athletes with persisting symptoms after SRC, vestibular dysfunction is associated with injury to the inferior vestibular nerve.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2022
Keywords
concussion, inferior vestibular nerve, persisting post-concussion symptoms, 7T MRI, sports-related concussion, vestibular dysfunction
National Category
Neurology
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-89459 (URN)10.1089/neu.2021.0447 (DOI)000766878500001 ()35171721 (PubMedID)2-s2.0-85131680804 (Scopus ID)
Funder
The Swedish Brain FoundationSwedish Research CouncilSwedish National Centre for Research in Sports
Note

Validerad;2022;Nivå 2;2022-06-21 (hanlid);

Funder: hospital ALF funds

Available from: 2022-03-08 Created: 2022-03-08 Last updated: 2022-06-21Bibliographically approved
Latini, F., Fahlström, M., Vedung, F., Stensson, S., Larsson, E.-M., Lubberink, M., . . . Marklund, N. (2022). Refined Analysis of Chronic White Matter Changes after Traumatic Brain Injury and Repeated Sports-Related Concussions: Of Use in Targeted Rehabilitative Approaches?. Journal of Clinical Medicine, 11(2), Article ID 358.
Open this publication in new window or tab >>Refined Analysis of Chronic White Matter Changes after Traumatic Brain Injury and Repeated Sports-Related Concussions: Of Use in Targeted Rehabilitative Approaches?
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2022 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 2, article id 358Article in journal (Refereed) Published
Abstract [en]

Traumatic brain injury (TBI) or repeated sport-related concussions (rSRC) may lead to long-term memory impairment. Diffusion tensor imaging (DTI) is helpful to reveal global white matter damage but may underestimate focal abnormalities. We investigated the distribution of post-injury regional white matter changes after TBI and rSRC. Six patients with moderate/severe TBI, and 12 athletes with rSRC were included ≥6 months post-injury, and 10 (age-matched) healthy controls (HC) were analyzed. The Repeatable Battery for the Assessment of Neuropsychological Status was performed at the time of DTI. Major white matter pathways were tracked using q-space diffeomorphic reconstruction and analyzed for global and regional changes with a controlled false discovery rate. TBI patients displayed multiple classic white matter injuries compared with HC (p < 0.01). At the regional white matter analysis, the left frontal aslant tract, anterior thalamic radiation, and the genu of the corpus callosum displayed focal changes in both groups compared with HC but with different trends. Both TBI and rSRC displayed worse memory performance compared with HC (p < 0.05). While global analysis of DTI-based parameters did not reveal common abnormalities in TBI and rSRC, abnormalities to the fronto-thalamic network were observed in both groups using regional analysis of the white matter pathways. These results may be valuable to tailor individualized rehabilitative approaches for post-injury cognitive impairment in both TBI and rSRC patients.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
traumatic brain injury, sport related concussion, memory impairment, diffusion tensor imaging, white matter lesions, rehabilitative approaches
National Category
Neurology
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-88824 (URN)10.3390/jcm11020358 (DOI)000747543900001 ()35054052 (PubMedID)2-s2.0-85122680071 (Scopus ID)
Funder
Swedish Research Council, 2018-02500_VRSwedish Research Council, P2019-0133Swedish Research Council, P2020-0116Swedish Research Council, P2021-0105
Note

Validerad;2022;Nivå 2;2022-01-17 (johcin);

Funder: Swedish Brain Foundation (FO2020-0147, FO2019-0190, FO2018-0166),  SRC under the framework of EU-ERA-NET NEURON CnsAFlame, Bissen Brain Walk and Selander Foundation

Available from: 2022-01-17 Created: 2022-01-17 Last updated: 2022-03-14Bibliographically approved
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