Features of postconcussion symptoms recovery after traumatic brain injury among military personnel
DOI:
https://doi.org/10.14739/2310-1210.2019.5.179424Keywords:
postconcussion syndrome, traumatic brain injury, cognitive disorders, electroencephalographyAbstract
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
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)