umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
One-year follow-up of patients with mild traumatic brain injury: post-concussion symptoms, disabilities and life satisfaction at follow-up in relation to serum levels of S-100B and neuron-specific enolase in acute phase
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
2005 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, no 5, 300-305 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate, in patients with mild traumatic brain injury, serum concentrations of S-100B and neurone-specific enolase in acute phase and post-concussion symptoms, disabilities and life satisfaction 1 year after the trauma.

DESIGN: Prospective study.

PATIENTS: Eighty-eight patients (age range 18-87 years).

METHODS: Blood samples were taken on admission and about 7 hours later. At follow-up 15 +/- 4 months later, the patients filled in questionnaires about symptoms (Rivermead Post Concussion Symptoms), disability (Rivermead Head Injury Follow-up) and life satisfaction (LiSat-11).

RESULTS: Concentrations of S-100B and neurone-specific enolase were regularly increased in the first blood sample. Of the 69 patients participating in the follow-up, 45% reported post-concussion symptom, 48% exhibited disability and 55% were satisfied with "life as a whole". In comparison with the "sick-leave" situation on admission to hospital, 3 patients were on sick-leave at the time of follow-up because of the head trauma. Stepwise forward logistic regression analysis revealed a statistically significant association (p<0.05) between disability and S-100B and dizziness.

CONCLUSION: In spite of frequent persistent symptoms, disabilities and low levels of life satisfaction, the sick-leave frequency was low at follow-up. The association between S-100B and disability supports the notion that long-term consequences of a mild brain injury may partly be a result of brain tissue injury.

Place, publisher, year, edition, pages
Taylor & Francis, 2005. Vol. 37, no 5, 300-305 p.
Keyword [en]
traumatic brain injury, head trauma, brain concussion, biochemical marker, S-100 proteins, life satisfaction, post-concussion symptoms
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:umu:diva-3927DOI: 10.1080/16501970510032910ISI: 000232225300005PubMedID: 16208863OAI: oai:DiVA.org:umu-3927DiVA: diva2:142839
Available from: 2004-05-05 Created: 2004-05-05 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Detection and outcome of mild traumatic brain injury in patients and sportsmen: persisting symptoms, disabilities and life satisfaction in relation to S-100B, NSE and cortisol
Open this publication in new window or tab >>Detection and outcome of mild traumatic brain injury in patients and sportsmen: persisting symptoms, disabilities and life satisfaction in relation to S-100B, NSE and cortisol
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Traumatic brain injuries are common (hospitalization incidence: 250-300 per 100.000 inhabitants/year) and a great majority of these injuries (80-85%) are classified as mild traumatic brain injury (MTBI/concussion). Many patients with MTBI (20-80%) suffer from subsequent persistent and often disabling symptoms. In previous studies serum levels of biochemical markers of brain tissue damage (S-100B and neuron-specific enolase, NSE) have been propounded to serve as predictors of persisting symptoms.In the present studies serum concentrations of S-100B, NSE and cortisol in acute phase and post-concussion symptoms, post-traumatic stress-related symptoms, disabilities and life satisfaction one year after the trauma, were investigated in 88 patients (53 men and 35 women) with MTBI. Serum concentrations of S-100B and NSE were also assessed in elite players (n=54) of typical contact sports (ice-hockey and soccer), which are known to be high risk activities with respect to head injury. Basketball players (n=18) were used as a control group.

A majority of patients with MTBI showed higher serum concentrations of S-100B, NSE and cortisol on admission compared with a second blood sample obtained about 7 hours later (p<0.001 for all analyses). Sequelae were common one year after the injury. Postconcussion symptoms were encountered in 45 % of the patients, stress-related symptoms in 17 % and disabilities in 48 %, but only 3 patients (4 %) were on sick-leave on follow-up due to the head trauma. There was a statistically significant negative correlation between the total score of life satisfaction and the total score of disability (r= -0.514, p<0.001). Symptoms on admission (dizziness, nausea) and S-100B were statistically significantly associated with disabilities (p<0.024, multiple logistic regression analysis). Nausea on admission was also statistically significantly associated with life satisfaction (p=0.004). A statistically significant association was found only for S-100B with early (0-1 week postinjury, p=0.008) and only for cortisol with late (more than 52 weeks post-injury, p=0.022) post-traumatic stress-related symptoms.

Concentrations of S-100B after game were statistically significantly increased in comparison with the levels before game (soccer, p<0.001; ice-hockey, p<0.001; basketball (p<0.001). Concentrations of NSE were only raised after soccer play (p<0.001). Increases in S-100-B (post-game minus pre-game values) were correlated to the number of jumps in basketball play (r=0.706, p=0.002). For soccer, increases in S-100B were correlated to the number of headers (r=0.428, p=0.02) and to the number of acceleration/deceleration events other than heading (r=0.453, p=0.02).

The findings provide support for the idea that injury of brain tissue is involved in the genesis of persisting disabilities and long-term changes of life satisfaction in MTBI. Since S-100B increases in serum were correlated to the number of headers and since soccer play also increased serum levels of NSE (in contrast to ice hockey and basketball), it seems that heading may have an impact on brain tissue. The studies have also shown that ordinary playing of the team sports in question (i.e. soccer, ice hockey and basketball) increases S-100B serum concentrations, which has to be taken into consideration when S-100B is used for the detection of injury of brain tissue in sportsmen with acute/overt head trauma during sport practice. An analysis of the biochemical markers of brain damage (in particular S-100B) may be an additional source of valuable information in the management of patients and sportsmen with MTBI. S-100B also seems to be promising for the prediction of impairments and disabilities after MTBI.

Place, publisher, year, edition, pages
Umeå: Umeå universitet. Institutionen för samhällsmedicin och rehabilitering, 2004. 64 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 896
Keyword
Medicine, traumatic brain injury, brain concussion, biochemical marker, S100 proteins, cortisol, post concussion symptoms, stress disorder posttraumatic, life satisfaction, sport, Medicin
National Category
Dermatology and Venereal Diseases
Research subject
Rehabilitation Medicine
Identifiers
urn:nbn:se:umu:diva-259 (URN)91-7305-665-0 (ISBN)
Public defence
2004-05-26, Hörsal B, 9tr, Tandläkarhögskolan, Norrlands Universitetssjukhus, Umeå, 13:15
Opponent
Supervisors
Available from: 2004-05-05 Created: 2004-05-05 Last updated: 2010-08-23Bibliographically approved

Open Access in DiVA

fulltext(184 kB)662 downloads
File information
File name FULLTEXT01.pdfFile size 184 kBChecksum SHA-512
74b99a72f6cdcc25e7fd51f2d4d6bf07dd9e54ba7c7989a4e60ea642959cd780e0017dc7b3bf0138d35ff8870765461f831d88310c3b506822700a60508c8cfe
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Stålnacke, Britt-MarieBjörnstig, UlfKarlsson, KurtSojka, Peter
By organisation
Department of Community Medicine and RehabilitationSurgeryClinical chemistryClinical PhysiologyRehabilitation Medicine
In the same journal
Journal of Rehabilitation Medicine
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar
Total: 662 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 4004 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf