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Post-Concussive Vestibular Dysfunction Is Related to Injury to the Inferior Vestibular Nerve
Department of Clinical Sciences Lund, Lund University, Neurosurgery, Skåne University Hospital, Lund, Sweden.
Department of Clinical Sciences Lund, Lund University, Neurosurgery, Skåne University Hospital, Lund, Sweden.
Department of Clinical Sciences Lund, Diagnostic Radiology, Lund University, Skåne University Hospital, Lund, Sweden.
Department of Radiological, Oncological and Pathological Sciences. Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
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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. Vol. 39, no 11-12, p. 829-840
Keywords [en]
concussion, inferior vestibular nerve, persisting post-concussion symptoms, 7T MRI, sports-related concussion, vestibular dysfunction
National Category
Neurology
Research subject
Medical Science
Identifiers
URN: urn:nbn:se:ltu:diva-89459DOI: 10.1089/neu.2021.0447ISI: 000766878500001PubMedID: 35171721Scopus ID: 2-s2.0-85131680804OAI: oai:DiVA.org:ltu-89459DiVA, id: diva2:1642861
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

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Tegner, Yelverton

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