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有轻度创伤性脑损伤终生经历的健康现役军人在静态平衡过程中表现出感觉反应性和感觉整合方面的细微缺陷。

Healthy Active Duty Military with Lifetime Experience of Mild Traumatic Brain Injury Exhibits Subtle Deficits in Sensory Reactivity and Sensory Integration During Static Balance.

作者信息

Wright W Geoffrey, Handy Justin D, Avcu Pelin, Ortiz Alejandro, Haran F Jay, Doria Michael, Servatius Richard J

机构信息

Neuromotor Sciences Program, College of Public Health, Temple University, 1800 N. Broad St., Philadelphia, PA.

Department of Veterans Affairs, Syracuse Veterans Affairs Medical Center, 800 Irving Ave., Syracuse, NY.

出版信息

Mil Med. 2018 Mar 1;183(suppl_1):313-320. doi: 10.1093/milmed/usx182.

Abstract

Postural control and stress reactivity were investigated in active duty coast guard personnel to determine whether they are sensitive to lifetime effects of mild traumatic brain injury (mTBI). A custom-designed and validated virtual reality-based computerized posturography device was used to assess postural stability, whereas emotional reactivity was assessed using the acoustic startle response (ASR), and neurocognitive performance was assessed using the defense-automated neurobehavioral assessment (DANA). It was hypothesized that residual and subtle postural control imbalance and deficits in cognitive and sensory reactivity would be evident in those reporting multiple lifetime mTBI. Active duty military personnel (N = 36; 7 females and 29 males) with no Deployment Limiting Medical Condition were recruited and tested on all assessments. Medical history information provided a history of head injury. Thirty-nine percent of participants reported having a previous mTBI (nine reporting one and five reporting more than one incident). No participant had experienced a head injury within the past year and all were symptom free. A significant effect of number of mTBI was found in the postural assessment (p = 0.002). Lifetime mTBI was associated with suppressed ASR magnitude (p = 0.03) but did not affect neurocognitive performance. The current findings provide new insight into ongoing controversies concerning sensitivity to functional deficits following mTBI and when the window for treatment or restoration ends.

摘要

对现役海岸警卫队人员的姿势控制和应激反应性进行了调查,以确定他们是否对轻度创伤性脑损伤(mTBI)的终生影响敏感。使用定制设计并经验证的基于虚拟现实的计算机化姿势描记设备评估姿势稳定性,而使用听觉惊吓反应(ASR)评估情绪反应性,并使用国防自动化神经行为评估(DANA)评估神经认知表现。研究假设是,在报告有多次终生mTBI的人员中,残留的和细微的姿势控制失衡以及认知和感觉反应性缺陷将很明显。招募了没有部署限制医疗状况的现役军人(N = 36;7名女性和29名男性),并对他们进行了所有评估测试。病史信息提供了头部受伤史。39%的参与者报告曾有过mTBI(9人报告有一次,5人报告有不止一次事件)。没有参与者在过去一年内经历过头部受伤,且所有人都没有症状。在姿势评估中发现mTBI次数有显著影响(p = 0.002)。终生mTBI与ASR幅度受抑制有关(p = 0.03),但不影响神经认知表现。目前的研究结果为有关mTBI后对功能缺陷的敏感性以及治疗或恢复窗口何时结束的持续争议提供了新的见解。

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