Traumatic brain injury (TBI) increases the risk of delayed neurodegenerative processes, including Parkinson’s disease (PD). Interleukin-1beta (IL-1β), a key pro-inflammatory cytokine, may promote secondary injury development after TBI. Conversely, neutralizing IL-1β was found to improve functional recovery following experimental TBI. However, the mechanisms underlying the behavioral improvements observed by IL-1β neutralization are still poorly understood. The present study investigated the role of IL-1β on the microglia response and neuronal changes in the globus pallidus in response to diffuse TBI. Mice were subjected to sham injury or the central fluid percussion injury (cFPI) (a model of traumatic axonal injury), and were randomly administered an IL-1β neutralizing or a control antibody at 30 min post-injury. The animals were analyzed at 2, 7, or 14 days post-injury. When compared to controls, mice subjected to cFPI TBI had increased microglia activation and dopaminergic innervation in the globus pallidus, and a decreased number of parvalbumin (PV) positive interneurons in the globus pallidus. Neutralization of IL-1β attenuated the microglia activation, prevented the loss of PV+ interneurons and normalized dopaminergic fiber density in the globus pallidus of brain-injured animals. These findings argue for an important role for neuro-inflammation in the PD-like pathology observed in TBI.

The aim of this study was to investigate the predictive power of aerobic test results and anthropometric variables on FIS-ranking of junior elite alpine skiers. Results from twenty-three male and female adolescent elite alpine skiers from two seasons were included in the multivariate statistical models. Physical work capacity was determined by V̇O2peak, blood lactate concentration ([HLa]b), and heart rate (HR) during ergometer cycling. Anthropometric variables were body stature, body weight and calculated BMI. No significant correlation between competitive performance and aerobic work capacity or anthropometric data was observed neither in male nor female adolescent skiers. Pre-season physical tests and anthropometric data could therefore not predict end-season FIS-ranking. The best regression (R2) and prediction (Q2) models of FIS slalom (SL) and giant slalom (GS) rank reached R2=0.51 to 0.86, Q2=−0.73 to 0.18, indicating no valid models. This study could not establish V̇O2peak and other included variables as predictors of competitive performance. When combining results from commonly used tests for alpine skiers, and applying multivariate statistical models, investigated tests seems of limited used for athletes, coaches, and ski federations. Performance-specific pre-season tests must be developed and validated for prediction of performance and guidance of exercise training.

Background: The EORTC questionnaires QLQ-C30 and QLQ-BN20 are commonly used to evaluate health-related quality of life in patients with meningiomas but have not undergone a disease-specific validation. The study aimed to address this issue and to determine the interrater reliability of WHO performance status (PS) assessments in these patients. Methods: This population-based study included prospectively enrolled intracranial meningiomas treated at Umeå University Hospital between October 14, 2010, and December 31, 2021, followed up until March 30, 2023. Patients were assessed by the EORTC questionnaires before and at 3 months after surgery. WHO PS categorized as high (0–1) or low (2–5) were evaluated for interrater reliability and used together with sick-leave status to determine the questionnaires’ clinical validity. Remaining psychometric properties of the questionnaires were analyzed by conventional methods. Results: Of 513 eligible surgeries, 454 (88.5%) had responded to at least 1 questionnaire. WHO PS interrater agreement was 94.4%. The EORTC questionnaires’ ability to distinguish between clinically distinct groups was high. Items correlated better with their own scale than others (most r > 0.70). Items measuring various aspects of the same construct showed good internal consistency (nearly all α > 0.70). Questionnaire responsiveness to symptom changes over time was acceptable. Several scales displayed floor and ceiling effects. Conclusions: The EORTC QLQ-C30 and QLQ-BN20 are overall valid instruments to evaluate patients with intracranial meningiomas but require awareness of certain limitations when specific functions and symptoms are addressed. WHO PS assessments can be applied to meningioma patients with high reproducibility between observers.

Competitive alpine skiing is a complex sport that requires high physical and technical competence. Testing the physical status of athletes may be important to increase their ability to achieve elite sport-specific performance. This study aimed to investigate the predictive power of the national test battery of the Swedish Olympic Committee (Fysprofilen) and anthropometric variables in the prediction of competitive performance of elite alpine skiers, indicated by Fédération Internationale de Ski points. Data from fourteen Swedish elite female alpine skiers were analyzed using bivariate and multivariate statistical methods. Physiological test results and anthropometric data could not generate significant bivariate or multivariate models for prediction of competitive performance. Multivariate regression (R2) and prediction (Q2) models for Fédération Internationale de Ski Slalom and Giant Slalom rank reached R2=0.27 to 0.43, Q2=+− 0.8 to−0.17, indicating no valid models. The overall interpretation of these and previous findings are that future test batteries must be validated before implemented, and that test results should be treated with caution when it comes to prediction of future competitive results. Applying tests that are not validated against competitive performance risk misleading coaches and training advisors who aim to increase the sports-specific performance of the individual athlete. Received: 02 March 2019 Received: 26 November 2019 Accepted: 27 November 2019 Publication Date: 09 June 2021 (online) © 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Malignant middle cerebral artery infarction (MMI) can cause life-threatening edema with high mortality rates. Randomized controlled trials (RCTs) have shown that decompressive hemicraniectomy (DC) can improve survival rate and functional outcome in selected MMI patients. However, real-world outcomes are less well described. To investigate DC indications, timing, and outcomes in MMI patients treated at 4 Swedish neurosurgical centers and the degree of alignment of real-world patient selection with eligibility criteria from 2 landmark RCTs-DESTINY I & II. This retrospective, Swedish multicenter (n = 4) cohort study included 335 MMI patients treated with DC between 2008 and 2022. Demographics, clinical and radiological status, surgical factors, and 6-month outcomes (modified Rankin Scale [mRS]) were collected and compared across centers and with DESTINY trials. Median age was 55 (48-61) years, and 75% were male. Pre-DC, median Glasgow Coma Scale Motor score was 5 (5-6) and Charlson Comorbidity Index score was 3 (3-4). DC was performed at a median of 38 (25-56) hours from stroke onset. Median mRS at 6 months was 4 (4-5), 24% had mRS ≤ 3, and mortality was 17%. Only 19% and 12% of patients would have qualified for DESTINY I and II trials, respectively. Indication and timing of DC as a treatment of MMI demonstrated notable discrepancies in surgical practice across centers and compared to landmark RCTs. However, despite differences in timing and indications for DC, the outcome did not differ significantly across centers. Our findings provide insight into the outcome of DC performed for MMI outside the strict criteria supported by level 1 evidence.

Background: Studies on intraosseous meningiomas requiring cranioplasty have been scarce, and surgical outcomes thus remain poorly characterized. Using a population-based, multicentre cohort of patients who had undergone resection of intraosseous meningioma with concurrent cranioplasty, we aimed to establish long-term outcomes, as well as rates and predictors of complications and tumour recurrence. Method: All patients who had undergone primary resection of an intraosseous meningioma with concurrent cranioplasty at four neurosurgical departments in Sweden between 2008 and 2022 were included. Data on patient demographics as well as tumour- and surgery-related data were collected retrospectively by scrutiny of medical records. Rates and predictors of surgical complications, and the composite outcome of tumour recurrence (including growth of residual tumour), were analysed using Cox regression. Results: Of the 119 patients included, 16% experienced surgical complications requiring reoperation, 10% underwent implant explantation, and 31% developed tumour recurrence. Choice of implant material differed significantly across the participating centres but did not influence complication rates. Markers of biological aggressiveness were associated with an increased risk of surgical complications and tumour recurrence. Conclusions: Surgical complications and tumour recurrence are common following resection of intraosseous meningiomas with concurrent cranioplasty. Rather than the material used for cranial reconstruction, biological and anatomical tumour-related factors were the strongest predictors of adverse outcomes.