Williams Christopher S, Weaver Lindell K, Lindblad Anne S, Kumar Siva, Langford Douglas R
Lovelace Biomedical Research, Albuquerque, New Mexico U.S.
CHMG Neurosciences, University of Colorado, Colorado Springs, Colorado U.S.
Undersea Hyperb Med. 2016 Aug-Sept;43(5):511-519.
Standard neurologic examinations may not detect abnormalities in U.S. military service members with persistent post-concussive symptoms following mild traumatic brain injury. The Brain Injury and Mechanisms of Action of Hyperbaric Oxygen for Persistent Post-Concussive Symptoms after Mild Traumatic Brain Injury Study (BIMA) enrolled 71 participants September 2012-May 2014. Participants received: comprehensive neurological and oculomotor exam; balance testing (Berg Balance Scale-BBS; Romberg Test-RT, Sharpened Romberg Test-SRT); olfactory function (Brief Smell Identification Test-BSIT). Two trained neurologists conducted the examinations at a central facility in Colorado Springs. Median age was 32 years (range 21-53), 99% male, 82% Caucasian, 49% PTSD, 28% most recent qualifying injury three months to one year prior to enrollment, 32% blast injuries only, and 73% multiple injuries. Some participants presented with abnormal facial sensation (15%), abnormal tandem gait (13%), and tremor (11%). 54% had abnormal near point of convergence (abnormal range 13-80 cm). 86% scored ≥ 55 on the BBS, with no participant scoring ⟨ 50. 49% scored ⟨ 30 seconds on the best trial of the SRT. RT was abnormal in 10%. 15% of participants scored ≤ 9 (out of 12) on BSIT, about twice what is expected in a normal population. The neurological examination found abnormalities across a range of testing, with convergence insufficiency and SRT having the most sensitivity.
ClinicalTrials.gov Identifier: NCT01611194; https://clinicaltrials.gov/show/NCT01611194.
标准神经系统检查可能无法检测出轻度创伤性脑损伤后出现持续性脑震荡后症状的美国军人的异常情况。轻度创伤性脑损伤后持续性脑震荡后症状的高压氧脑损伤及作用机制研究（BIMA）于2012年9月至2014年5月招募了71名参与者。参与者接受了：全面的神经和动眼神经检查；平衡测试（伯格平衡量表 - BBS；罗姆伯格试验 - RT，改良罗姆伯格试验 - SRT）；嗅觉功能（简易嗅觉识别测试 - BSIT）。两名经过培训的神经科医生在科罗拉多斯普林斯的一个中心机构进行检查。中位年龄为32岁（范围21 - 53岁），99%为男性，82%为白种人，49%患有创伤后应激障碍（PTSD），28%在入组前三个月至一年有最近一次符合条件的损伤，32%仅为爆炸伤，73%为多处损伤。一些参与者出现面部感觉异常（15%）、异常串联步态（13%）和震颤（11%）。54%的人近点集合异常（异常范围13 - 80厘米）。86%的人在BBS上得分≥55，没有参与者得分＜50。49%的人在SRT的最佳试验中得分＜30秒。10%的人RT异常。15%的参与者在BSIT上得分≤9（满分12分），约为正常人群预期值的两倍。神经系统检查在一系列测试中发现了异常情况，集合不足和SRT的敏感性最高。
ClinicalTrials.gov标识符：NCT01611194；https://clinicaltrials.gov/show/NCT01611194 。
