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Post-concussive vestibular dysfunction is related to injury to the inferior vestibular nerve

Gard, Anna LU ; Al-Husseini, Ali LU orcid ; Kornaropoulos, Evgenios N LU ; De Maio, Alessandro ; Tegner, Yelverton ; Björkman-Burtscher, Isabella LU ; Markenroth Bloch, Karin LU orcid ; Nilsson, Markus LU ; Magnusson, Måns LU orcid and Marklund, Niklas LU orcid (2022) In Journal of Neurotrauma 39(44877). p.829-840
Abstract

Symptoms of vestibular dysfunction such as dizziness and vertigo are common following sports-related concussions (SRC) and associated with a worse outcome and a prolonged recovery. Vestibular dysfunction following SRC can be due to 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 SRC athletes with 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 - that underwent symptom rating, a detailed test battery of vestibular function and 7T MRI with diffusion tensor imaging (DTI), diffusion kurtosis... (More)

Symptoms of vestibular dysfunction such as dizziness and vertigo are common following sports-related concussions (SRC) and associated with a worse outcome and a prolonged recovery. Vestibular dysfunction following SRC can be due to 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 SRC athletes with 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 - that underwent symptom rating, a detailed test battery of vestibular function and 7T MRI with diffusion tensor imaging (DTI), 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 3 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 grey and white matter volumes were similar in SRC athletes and controls. Compared to controls, pathological video head impulse test results (vHIT; p<0.001) and cervical vestibular evoked myogenic potentials (cVEMP; p=0.002) were observed in SRC athletes, indicating peripheral vestibular dysfunction and specifically suggesting injury to the inferior vestibular nerve. In athletes with persisting symptoms following SRC, vestibular dysfunction is associated with injury to the inferior vestibular nerve.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
brain injrury, vestibular, Sports injury, vestibular nerve
in
Journal of Neurotrauma
volume
39
issue
44877
pages
829 - 840
publisher
Mary Ann Liebert, Inc.
external identifiers
  • scopus:85131680804
  • pmid:35171721
ISSN
1557-9042
DOI
10.1089/neu.2021.0447
language
English
LU publication?
yes
id
875523dd-cb11-4a04-b410-256c10f27b67
date added to LUP
2022-02-27 21:12:05
date last changed
2025-03-21 21:12:18
@article{875523dd-cb11-4a04-b410-256c10f27b67,
  abstract     = {{<p>Symptoms of vestibular dysfunction such as dizziness and vertigo are common following sports-related concussions (SRC) and associated with a worse outcome and a prolonged recovery. Vestibular dysfunction following SRC can be due to 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 SRC athletes with 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 - that underwent symptom rating, a detailed test battery of vestibular function and 7T MRI with diffusion tensor imaging (DTI), 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 3 controls (p=0.001). Athletes with vestibular dysfunction reported more pronounced symptoms on the Dizziness Handicap Inventory (DHI; p&lt;0.001) and the Hospital Anxiety and Depression Scale (HADS; p&lt;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 grey and white matter volumes were similar in SRC athletes and controls. Compared to controls, pathological video head impulse test results (vHIT; p&lt;0.001) and cervical vestibular evoked myogenic potentials (cVEMP; p=0.002) were observed in SRC athletes, indicating peripheral vestibular dysfunction and specifically suggesting injury to the inferior vestibular nerve. In athletes with persisting symptoms following SRC, vestibular dysfunction is associated with injury to the inferior vestibular nerve.</p>}},
  author       = {{Gard, Anna and Al-Husseini, Ali and Kornaropoulos, Evgenios N and De Maio, Alessandro and Tegner, Yelverton and Björkman-Burtscher, Isabella and Markenroth Bloch, Karin and Nilsson, Markus and Magnusson, Måns and Marklund, Niklas}},
  issn         = {{1557-9042}},
  keywords     = {{brain injrury; vestibular; Sports injury; vestibular nerve}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{44877}},
  pages        = {{829--840}},
  publisher    = {{Mary Ann Liebert, Inc.}},
  series       = {{Journal of Neurotrauma}},
  title        = {{Post-concussive vestibular dysfunction is related to injury to the inferior vestibular nerve}},
  url          = {{http://dx.doi.org/10.1089/neu.2021.0447}},
  doi          = {{10.1089/neu.2021.0447}},
  volume       = {{39}},
  year         = {{2022}},
}