| 1. |
- Clarke, Gerard Janez Brett, et al.
(författare)
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Chronic immunosuppression across 12 months and high ability of acute and subacute CNS-injury biomarker concentrations to identify individuals with complicated mTBI on acute CT and MRI.
- 2024
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Ingår i: Journal of Neuroinflammation. - 1742-2094. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Identifying individuals with intracranial injuries following mild traumatic brain injury (mTBI), i.e. complicated mTBI cases, is important for follow-up and prognostication. The main aims of our study were (1) to assess the temporal evolution of blood biomarkers of CNS injury and inflammation in individuals with complicated mTBI determined on computer tomography (CT) and magnetic resonance imaging (MRI); (2) to assess the corresponding discriminability of both single- and multi-biomarker panels, from acute to chronic phases after injury.Patients with mTBI (n=207), defined as Glasgow Coma Scale score between 13 and 15, loss of consciousness<30min and post-traumatic amnesia<24h, were included. Complicated mTBI - i.e., presence of any traumatic intracranial injury on neuroimaging - was present in 8% (n=16) on CT (CT+) and 12% (n=25) on MRI (MRI+). Blood biomarkers were sampled at four timepoints following injury: admission (within 72h), 2 weeks (±3 days), 3 months (±2 weeks) and 12 months (±1 month). CNS biomarkers included were glial fibrillary acidic protein (GFAP), neurofilament light (NFL) and tau, along with 12 inflammation markers.The most discriminative single biomarkers of traumatic intracranial injury were GFAP at admission (CT+:AUC=0.78; MRI+:AUC=0.82), and NFL at 2 weeks (CT+:AUC=0.81; MRI+:AUC=0.89) and 3 months (MRI+:AUC=0.86). MIP-1β and IP-10 concentrations were significantly lower across follow-up period in individuals who were CT+and MRI+. Eotaxin and IL-9 were significantly lower in individuals who were MRI+only. FGF-basic concentrations increased over time in MRI- individuals and were significantly higher than MRI+individuals at 3 and 12 months. Multi-biomarker panels improved discriminability over single biomarkers at all timepoints (AUCs>0.85 for admission and 2-week models classifying CT+and AUC≈0.90 for admission, 2-week and 3-month models classifying MRI+).The CNS biomarkers GFAP and NFL were useful single diagnostic biomarkers of complicated mTBI, especially in acute and subacute phases after mTBI. Several inflammation markers were suppressed in patients with complicated versus uncomplicated mTBI and remained so even after 12 months. Multi-biomarker panels improved diagnostic accuracy at all timepoints, though at acute and 2-week timepoints, the single biomarkers GFAP and NFL, respectively, displayed similar accuracy compared to multi-biomarker panels.
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| 2. |
- Clarke, Gerard, et al.
(författare)
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Longitudinal Associations Between Persistent Post-Concussion Symptoms and Blood Biomarkers of Inflammation and CNS-Injury Following Mild Traumatic Brain Injury
- 2024
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Ingår i: Journal of neurotrauma. - 1557-9042. ; 41:7-8, s. 862-878
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Tidskriftsartikel (refereegranskat)abstract
- The aim of our study was to investigate the biological underpinnings of persistent post-concussion symptoms (PPCS) at 3 months following mild traumatic brain injury (mTBI). Patients (n = 192, 16-60 years) with mTBI, defined as Glasgow Coma Scale (GCS) score between 13 and 15, loss of consciousness (LOC)<30 min and post-traumatic amnesia (PTA)<24 hours were included. Blood samples were collected at admission (within 72 hours), 2 weeks and 3 months. From the blood, concentrations of blood biomarkers associated with CNS damage (GFAP, NFL and tau) and inflammation (IFN, IL-8, eotaxin, MIP-1, MCP-1, IP-10, IL-17A, IL-9, TNF, FGF-basic PDGF and IL-1ra) were obtained. Demographic and injury-related factors investigated were age, sex, GCS score, LOC, PTA duration, traumatic intracranial finding on MRI (within 72 hours), and extracranial injuries. Delta values, i.e., timepoint differences in biomarker concentrations between 2 weeks minus admission and 3 months minus admission, were also calculated. PPCS was assessed with the British Columbia Post-Concussion Symptom Inventory (BC-PSI). In single variable analyses, longer PTA duration and a higher proportion of intracranial findings on MRI were found in the PPCS group, but no single biomarker differentiated those with PPCS from those without. In multivariable models, female sex, longer PTA duration, MRI findings and lower GCS scores were associated with increased risk of PPCS. Inflammation markers, but not GFAP, NFL or tau, were associated with PPCS. At admission, higher concentrations of IL-8 and IL-9 and lower concentrations of TNF, IL-17a, and MCP-1 were associated with greater likelihood of PPCS; at 2 weeks, higher IL-8 and lower IFN were associated with PPCS; at 3 months, higher PDGF was associated with PPCS. Higher delta values of PDGF, IL-17A and FGF-basic at 2 weeks compared to admission, MCP-1 at 3 months compared to admission and TNF at 2 weeks and 3 months compared to admission were associated with greater likelihood of PPCS. Higher IL-9 delta values at both timepoint comparisons were negatively associated with PPCS. Discriminability of individual CNS-injury and inflammation biomarkers for PPCS was around chance level, while the optimal combination of biomarkers yielded AUCs between 0.62 and 0.73. We demonstrate a role of biological factors on PPCS, including both positive and negative effects of inflammation biomarkers that differed based on sampling timepoint after mTBI. PPCS was associated more with acute inflammatory processes, rather than ongoing inflammation or CNS-injury biomarkers. However, the modest discriminative ability of the models suggests other factors are more important in the development of PPCS.
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| 3. |
- Hellenes, Olav Morkved, et al.
(författare)
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Regular moderate exercise during pregnancy does not have an adverse effect on the neurodevelopment of the child
- 2015
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 104:3, s. 285-291
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Tidskriftsartikel (refereegranskat)abstract
- AimCurrent U.S. guidelines suggest that pregnant women should exercise regularly during pregnancy, and we examined the neurodevelopment of the children whose mothers had taken that advice. MethodsThis Norwegian study included 188 children whose mothers had followed a structured exercise protocol and 148 control children whose mothers had not. Their cognitive, language and motor skills were assessed at 18months of age by the Bayley Scales of Infant Development-III and daily life functioning with the Ages and Stages Questionnaire. ResultsNo significant differences were found between the two groups. Subgroup analyses revealed that the children whose mothers had exercised had a slightly lower motor composite score (mean: 97.6, 95% CI: 96.0-99.2) than the control group (mean: 100.0, 95% CI: 98.6-101.5) (p=0.03). Boys in the intervention group had lower fine motor scores (mean: 10.6, 95% CI: 10.3-11.0) than boys in the control group (mean: 11.5, 95% CI: 11.0-11.9) (p=0.01). ConclusionOur main finding was that regular moderate exercise during pregnancy does not adversely affect neurodevelopment in children. The lower motor scores in the subgroup analyses are probably clinically insignificant, but the lower fine motor scores for boys in the intervention group warrant further research.
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| 4. |
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| 5. |
- Nilsen, Roy M., et al.
(författare)
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Preconception Folic Acid Supplement Use in Immigrant Women (1999-2016)
- 2019
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 11:10
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Tidskriftsartikel (refereegranskat)abstract
- This study examines how preconception folic acid supplement use varied in immigrant women compared with non-immigrant women. We analyzed national population-based data from Norway from 1999-2016, including 1,055,886 pregnancies, of which 202,234 and 7,965 were to 1st and 2nd generation immigrant women, respectively. Folic acid supplement use was examined in relation to generational immigrant category, maternal country of birth, and length of residence. Folic acid supplement use was lower overall in 1st and 2nd generation immigrant women (21% and 26%, respectively) compared with Norwegian-born women (29%). The lowest use among 1st generation immigrant women was seen in those from Eritrea, Ethiopia, Morocco, and Somalia (around 10%). The highest use was seen in immigrant women from the United States, the Netherlands, Denmark, and Iceland (>30%). Folic acid supplement use increased with increasing length of residence in immigrant women from most countries, but the overall prevalence was lower compared with Norwegian-born women even after 20 years of residence (adjusted odds ratio: 0.63; 95% confidence interval: 0.60-0.67). This study suggests that immigrant women from a number of countries are less likely to use preconception folic acid supplements than non-immigrant women, even many years after settlement.
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| 6. |
- Strandberg, Ragnhild B., et al.
(författare)
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Gestational diabetes mellitus by maternal country of birth and length of residence in immigrant women in Norway
- 2021
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Ingår i: Diabetic Medicine. - : John Wiley & Sons. - 0742-3071 .- 1464-5491. ; 38:6
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Immigrant women are at higher risk for gestational diabetes mellitus (GDM) than non-immigrant women. This study described the prevalence of GDM in immigrant women by maternal country of birth and examined the associations between immigrants' length of residence in Norway and GDM.Methods: This Norwegian national population-based study included 192,892 pregnancies to immigrant and 1,116,954 pregnancies to non-immigrant women giving birth during the period 1990-2013. Associations were reported as odds ratios (ORs) with 95% confidence intervals (CIs) using logistic regression models, adjusted for year of delivery, maternal age, marital status, health region, parity, education and income.Results: The prevalence and adjusted OR [CI] for GDM were substantially higher in immigrant women from Bangladesh (7.4%, OR 8.38 [5.41, 12.97]), Sri Lanka (6.3%, OR 7.60 [6.71, 8.60]), Pakistan (4.3%, OR 5.47 [4.90, 6.11]), India (4.4%, OR 5.18 [4.30, 6.24]) and Morocco (4.3%, OR 4.35 [3.63, 5.20]) compared to non-immigrants (prevalence 0.8%). Overall, GDM prevalence increased from 1.3% (OR 1.25 [1.14, 1.36]) to 3.3% (OR 2.55 [2.39, 2.71]) after 9 years of residence in immigrants compared to non-immigrant women. This association was particularly strong for women from South Asia.Conclusions: Gestational diabetes mellitus prevalence varied substantially between countries of maternal birth and was particularly high in immigrants from Asian countries. GDM appeared to increase with longer length of residence in certain immigrant groups.
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