Features of postconcussion symptoms recovery after traumatic brain injury among military personnel

Authors

  • A. V. Shvets Ukrainian Military Medical Academy, Kyiv,
  • A. Yu. Kikh Military Personnel of UAF Ukraine, Irpin,
  • I. A. Lukianchuk Ukrainian Military Medical Academy, Kyiv,

DOI:

https://doi.org/10.14739/2310-1210.2019.5.179424

Keywords:

postconcussion syndrome, traumatic brain injury, cognitive disorders, electroencephalography

Abstract

 

Traumatic brain injuries due to hostilities inEastern Ukrainein 2017 accounted for 30.8% of all mechanical combat damage and injuries and are an important problem because of postconcussion syndrome manifestation in the long-term period.

Purpose – to study the features of postconcussion symptoms recovery among combatants during their rehabilitation in hospital conditions based on electroencephalography and the dynamics of psychophysiological characteristics assessment.

Materials and methods. 42 combatants aged 35–45 years who suffered a closed craniocerebral injury during 2017–2018 (more than 3 months after head injury) and 76 healthy men the same age, constituted group II (control), were involved in the study. The study evaluated and analyzed the results of electroencephalography (EEG), manifestations of postconcussion symptoms using   К. Cicerone   modified special questionnaire as well as the characteristics of attentiveness and short-term memory using a special computer program.

Results. Among individuals with postconcussion syndrome, the functioning of non-specific brain systems was found to be impaired making dysregulation changes in the electrical activity of the brain stable and long-lasting. It was shown that the applied rehabilitation programs had a positive effect on the balance and improvement of the brain bioelectrical activity rhythms and, accordingly, the functional activity of these structures (θ and δ characteristics of EEG spectrum improved after rehabilitation (P < 0.05), which may indicate the inclusion of neuro-emotional stress coping mechanisms during rehabilitation in inpatient conditions). Somatic manifestations which very often occur and impair performance, as well as definite complaints from the cognitive sphere, reliably decreased (P < 0.05), but complaints due to sensory functions impairment remained almost unchanged in 17 % of people after the rehabilitation course. The characteristics of attentiveness and short-term memory had a positive (P < 0.001) dynamics after the rehabilitation course and did not exceed the calculated standard indicators.

Conclusions. The features of postconcussion symptoms recovery among combatants during their rehabilitation in hospital conditions in terms of θ and δ characteristics of the EEG spectrum have been revealed. The presence of significant (P < 0.001) differences in objective characteristics of cognitive functions in patients before rehabilitation compared with the control group (below standard values), as well as significant (P < 0.001) positive dynamics of attentiveness and short-term memory after rehabilitation of military personnel with postconcussion symptomatology and approximation of these characteristics to standard values have been found. It has been noted that the diagnosis of cognitive disorders associated with traumatic brain injury should be essentially based on the results of neuropsychological objective testing of attentiveness and short-term memory, since they are more dynamic (P < 0.001) indicators compared with complaints relating to cognitive function changes.

 

References

Shvets, A., & Kich, A. (2017). The decision support model for forecasting of wounded and sick restoration in hospital conditions based on psychophysiological data. Kibernetika i vychislitel'naya tekhnika, 3(189), 79–96. doi: doi.org/10.15407/kvt188.02.075

Ianof, J. N., & Anghinah, R. (2017). Traumatic brain injury: An EEG point of view. Dement Neuropsychol, 11(1), 3–5. doi: 10.1590/1980-57642016dn11-010002

Minen, M. T., Boubour, A., Walia, H., & Barr, W. (2016). Post-Concussive Syndrome: a Focus on Post-Traumatic Headache and Related Cognitive, Psychiatric, and Sleep Issues, Curr Neurol Neurosci Rep, 16(11), 100. doi: 10.1007/s11910-016-0697-7

Dean, Ph. J. A., Sato, J. R., Vieira, G., McNamara, A., & Sterr, A. (2015) Long-term structural changes after mTBI and their relation to post-concussion symptoms. Brain Injury, 29(10), 1211–1218. doi: 10.3109/02699052.2015.1035334

Tator, C. H., Davis, H. S., Dufort, P. A., Tartaglia, M. C., Davis, K. D., Ebraheem, A., & Hiploylee, C. (2016). Postconcussion syndrome: emographics and predictors in 221 patients, J. Neurosurg, 125(5), 1206–1216. doi: 10.3171/2015.6.JNS15664

Nuwer, M. R., Comi, G., Emerson, R., Fuglsang-Frederiksen, A., Guérit, J. M., Hinrichs, H.,et al. (1998). IFCN standards for digital recording of clinical EEG. The International Federation of Clinical Neurophysiology. Electroencephalogr Clin Neurophysiol Suppl, 106(3), 259–61. doi: 10.1016/s0013-4694(97)00106-5

Zhirmunskaya, E. A. (1972). Bioe'lektricheskaya aktivnost' zdorovogo i bol'nogo mozga cheloveka [Bioelectric activity of a healthy and sick human brain]. Rukovodstvo po fiziologii. Klinicheskaya fiziologiya. Leningrad: Nauka. [in Russian].

Cicerone, K. D., & Kalmar, K. (1995). Persistent postconcussion syndrome: The structure of subjective complaints after mild traumatic brain injury, Journal of Head Trauma Rehabilitation, 10(3), 1–17. http://dx.doi.org/10.1097/00001199-199510030-00002

Shvets, A. V., Каlnysh, V. V., & Shevchuk, O. V. (2008). Svidotstvo pro reiestratsiiu avtorskoho prava na tvir «Kompiuterna prohrama «Peacekeepers’ psychophysiology research program P.P.R.P» vid 12.06.2008 №24720 [Certificate of registration of copyright for the work «Computer software «Peacekeepers’ psychophysiology research program P.P.R.P» from June 12, 2008. №24720 ]. [in Ukrainian].

Каlnysh, V. V., & Shvets, A. V. (2008). Udoskonalennia metodolohii vyznachennia psykhofiziolohichnykh kharakterystyk operatoriv [Improvement of methodology for determining operators’ psychophysiological characteristics]. Ukrainskyi zhurnal z problem medytsyny pratsi, 16(4), 49–54. [in Ukrainian].

Haneef, Z., Levin, H. S., Frost, J. D. Jr., & Mizrahi, E. M. (2013). Electroencephalography and quantitative electroencephalography in mild traumatic brain injury, J Neurotrauma, 30(8), 653–656. doi: 10.1089/neu.2012.2585

McInnes, K., Friesen, C. L., MacKenzie, D. E., Westwood, D. A., & Boe, S. G. (2017). Mild Traumatic Brain Injury (mTBI) and chronic cognitive impairment: A scoping review. PLoS One, 12(4), e0174847. doi: 10.1371/journal.pone.0174847

Broshek, D. K., De Marco, A.P., & Freeman J.R. (2015). A review of post-concussion syndrome and psychological factors associated with concussion, Brain Injury, 29(2), 228–237. doi: 10.3109/02699052.2014.974674

O'Neil, M. E., Kathleen, M. C., Carlson, F., Roost, M., Laman-Maharg, B., Twamley, E. W., Iet al. (2017). Postconcussion symptoms reported by Operation Enduring Freedom/Operation Iraqi Freedom veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress disorder, Journal of Clinical and Experimental Neuropsychology, 39(5), 449–458. doi: 10.1080/13803395.2016.1232699

Hiploylee, C., Dufort, P. A., Davis, H. S., Wennberg, R. A., Tartaglia, M. C., Mikulis, D., et al. (2015). Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers, Journal of Neurotrauma, 34(8), 1511–1523. doi: 10.1089/neu.2016.4677

Moser, R. S., Schatz, Ph., & Lichtenstein, J. D. (2015). The Importance of Proper Administration and Interpretation of Neuropsychological Baseline and Postconcussion Computerized Testing, Applied Neuropsychology: Child, 4(1), 41–48, doi: 10.1080/21622965.2013.791825

How to Cite

1.
Shvets AV, Kikh AY, Lukianchuk IA. Features of postconcussion symptoms recovery after traumatic brain injury among military personnel. Zaporozhye Medical Journal [Internet]. 2019Oct.1 [cited 2024Nov.23];(5). Available from: http://zmj.zsmu.edu.ua/article/view/179424

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Original research