Multisensory impairment reported by veterans with and without mild traumatic brain injury history

Center for Organization, Leadership and Management Research, VA Boston Healthcare System, 150 S. Huntington Ave (152M), Boston, MA 02130. .
The Journal of Rehabilitation Research and Development (Impact Factor: 1.43). 10/2012; 49(7):971-84. DOI: 10.1682/JRRD.2011.06.0099
Source: PubMed


With the use of Veterans Health Administration and Department of Defense databases of veterans who completed a Department of Veterans Affairs comprehensive traumatic brain injury (TBI) evaluation, the objectives of this study were to (1) identify the co-occurrence of self-reported auditory, visual, and vestibular impairment, referred to as multisensory impairment (MSI), and (2) examine demographic, deployment-related, and mental health characteristics that were potentially predictive of MSI. Our sample included 13,746 veterans with either a history of deployment-related mild TBI (mTBI) (n = 9,998) or no history of TBI (n = 3,748). The percentage of MSI across the sample was 13.9%, but was 17.4% in a subsample with mTBI history that experienced both nonblast and blast injuries. The factors that were significantly predictive of reporting MSI were older age, being female, lower rank, and etiology of injury. Deployment-related mTBI history, posttraumatic stress disorder, and depression were also significantly predictive of reporting MSI, with mTBI history the most robust after adjusting for these conditions. A better comprehension of impairments incurred by deployed servicemembers is needed to fully understand the spectrum of blast and nonblast dysfunction and may allow for more targeted interventions to be developed to address these issues.

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Available from: Katherine Mary Iverson, Jan 21, 2014
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    • "Additionally, reports of multisensory impairment after brain damage are rare (Pogoda et al., 2012). Visual field loss may occur in combination with another sensory impairment, which theoretically multiplies individual difficulties complicating individual efforts to compensate for either sensory deficit. "
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    ABSTRACT: While there are reports on vision-related quality of life in patients with vision impairment caused by both ophthalmic and brain diseases, little is known about mental distress. In fact, mental distress after cerebral visual injury has been widely ignored. Mental health symptoms were assessed in 122 participants with visual field defects after brain damage (72 male, mean age 58.1 ± 15.6 years), who completed the German Brief Symptom Inventory (BSI) at their homes after they had been asked by phone for their participation. Clinically relevant mental distress was present in 25.4% of participants with cerebral visual injury. In case of multisensory impairment, an increased amount and intensity of mental distress symptoms was observed compared to the subsample with only visual impairment. Assessment of comorbid mental health symptoms appears to be clinically meaningful in brain-damaged patients with visual sensory impairment. In case of clinically relevant mental distress, psychological supportive therapies are advisable especially in subjects with cerebral visual injury and comorbidities affecting other sensory modalities as well.
    Frontiers in Aging Neuroscience 05/2015; 7. DOI:10.3389/fnagi.2015.00051 · 4.00 Impact Factor
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    • "Brain injuries represent a higher proportion of injuries compared with previous conflicts such as the Vietnam War, in part because the modern body armor has altered the pattern of combat injuries. Although most patients with mTBI recover, persistent mTBI can include incapacitating multisensory and neuropsychological symptoms and other delayed problems include depression and behavioral dysfunction [2] [3] [4]. In 2011, there were 1,542,625 veterans receiving compensation for tinnitus and hearing loss problems alone. "
    Alzheimer's and Dementia 06/2014; 10(3):S94–S96. DOI:10.1016/j.jalz.2014.05.001 · 12.41 Impact Factor
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    ABSTRACT: Auditory system functions, from peripheral sensitivity to central processing capacities, are all at risk from a blast event. Accurate encoding of auditory patterns in time, frequency, and space are required for a clear understanding of speech and accurate localization of sound sources in environments with background noise, multiple sound sources, and/or reverberation. Further work is needed to refine the battery of clinical tests sensitive to the sorts of central auditory dysfunction observed in individuals with blast exposure. Treatment options include low-gain hearing aids, remote-microphone technology, and auditory-training regimens, but clinical evidence does not yet exist for recommending one or more of these options. As this population ages, the natural aging process and other potential brain injuries (such as stroke and blunt trauma) may combine with blast-related brain changes to produce a population for which the current clinical diagnostic and treatment tools may prove inadequate. It is important to maintain an updated understanding of the scope of the issues present in this population and to continue to identify those solutions that can provide measurable improvements in the lives of Veterans who have been exposed to high-intensity blasts during the course of their military service.
    The Journal of Rehabilitation Research and Development 01/2012; 49(7):1059-1074. DOI:10.1682/JRRD.2010.09.0166 · 1.43 Impact Factor
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