Belhassen Serge, Mat Quentin, Ferret Claude, Clavel Robert, Renaud Bernard, Cabaraux Pierre
Groupe d'Etudes, de Recherche, d'Information et de Formation sur les Activités Posturo-Cinétiques (Gerifap), Juvignac, France.
Department of Otorhinolaryngology, Centre Hospitalier Universitaire (CHU) Charleroi, Charleroi, Belgium.
Brain Neurorehabil. 2023 Jul 7;16(2):e15. doi: 10.12786/bn.2023.16.e15. eCollection 2023 Jul.
Mild traumatic brain injury (mTBI) and whiplash injury (WI) may lead to long-term disabling consequences known as post-concussive syndrome (PCS) and whiplash-associated disorders (WADs). PCS and WAD patients commonly complain of conditions encompassing dizziness, vertigo, headache, neck pain, visual complaints, anxiety, and neurocognitive dysfunctions. A proper medical work-up is a priority in order to rule out any acute treatable consequences. However investigations may remain poorly conclusive. Gathered in the head and neck structures, the ocular sensorimotor, the vestibular, and the cervical proprioceptive systems, all involved in postural control, may be damaged by mTBI or WI. Their dysfunctions are associated with a wide range of functional disorders including symptoms reported by PCS and WAD patients. In addition, the stomatognathic system needs to be specifically assessed particularly when associated to WI. Evidence for considering the post-traumatic impairment of these systems in PCS and WAD-related symptoms is still lacking but seems promising. Furthermore, few studies have considered the assessment and/or treatment of these widely interconnected systems from a comprehensive perspective. We argue that further research focusing on consequences of mTBI and WI on the systems involved in the postural control are necessary in order to bring new perspective of treatment.
轻度创伤性脑损伤(mTBI)和挥鞭样损伤(WI)可能导致称为脑震荡后综合征(PCS)和挥鞭样损伤相关疾病(WADs)的长期致残后果。PCS和WAD患者通常抱怨有头晕、眩晕、头痛、颈部疼痛、视觉问题、焦虑和神经认知功能障碍等情况。为了排除任何急性可治疗后果,进行适当的医学检查是首要任务。然而,检查结果可能仍然缺乏定论。眼部感觉运动系统、前庭系统和颈部本体感觉系统集中在头颈部结构中,均参与姿势控制,可能会因mTBI或WI而受损。它们的功能障碍与广泛的功能紊乱有关,包括PCS和WAD患者报告的症状。此外,口颌系统需要特别评估,尤其是与WI相关时。在PCS和WAD相关症状中考虑这些系统的创伤后损伤的证据仍然缺乏,但似乎很有前景。此外,很少有研究从综合角度考虑对这些广泛相互关联的系统进行评估和/或治疗。我们认为,有必要进一步开展研究,关注mTBI和WI对参与姿势控制的系统的影响,以便带来新的治疗视角。