Characterizing effects of mild traumatic brain injury and posttraumaticstress disorder on balance impairments in blast-exposed servicemembersand Veterans using computerized posturography

摘要

The high rate of blast exposures experienced by U.S.servicemembers (SMs) during the recent conflicts in Iraq andAfghanistan has resulted in frequent combatrelated mild traumaticbrain injuries (mTBIs). Dizziness and postural instabilitycan persist after mTBI as a component of postconcussion syndrome,but also occur among the somatic complaints of posttraumaticstress disorder (PTSD). The goals of this study were toexamine the use of computerized posturography testing (CPT) toobjectively characterize chronic balance deficits after mTBI andto explore the utility of CPT in distinguishing between combatand blastexposed participants with and without mTBI andPTSD. Data were analyzed from a subject pool of 166 combatexposedSMs and Veterans who had a blast experience within thepast 2 yr while deployed. Using nonparametric tests and measuresof impairment, we found that balance was deficient in participantsdiagnosed with mTBI with posttraumatic amnesia(PTA) or PTSD versus those with neither and that deficits wereamplified for participants with both diagnoses. In addition,unique deficiencies were found using CPT for individuals havingisolated mTBI with PTA and isolated PTSD. Computerized balanceassessment offers an objective technique to examine thephysiologic effects and provide differentiation between participantswith combatassociated mTBI and PTSD.