Citation

Franke LM, Czarnota JN, Ketchum JM, Walker WC. J. Head Trauma Rehabil. 2014; 30(1): E34-46.

Affiliation

Defense and Veterans Brain Injury Center, Richmond, Virginia (Drs Franke and Walker); Departments of Physical Medicine and Rehabilitation (Drs Franke and Walker) and Biostatistics (Ms Czarnota and Dr Ketchum), School of Medicine, Virginia Commonwealth University, Richmond, Virginia; and The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland (Drs Franke and Walker).

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000042

PMID

24695267

Abstract

OBJECTIVE:: To determine the factor structure of persistent postconcussive syndrome symptoms in a blast-exposed military sample and validate factors against objective and symptom measures. SETTING:: Veterans Affairs medical center and military bases. PARTICIPANTS:: One hundred eighty-one service members and veterans with at least 1 significant exposure to blast during deployment within the 2 years prior to study enrollment.

DESIGN:: Confirmatory and exploratory factor analyses of the Rivermead Postconcussion Questionnaire. MAIN MEASURES:: Rivermead Postconcussion Questionnaire, PTSD (posttraumatic stress disorder) Symptom Checklist-Civilian, Center for Epidemiological Studies Depression scale, Sensory Organization Test, Paced Auditory Serial Addition Test, California Verbal Learning Test, and Delis-Kaplan Executive Function System subtests.

RESULTS:: The 3-factor structure of persistent postconcussive syndrome was not confirmed. A 4-factor structure was extracted, and factors were interpreted as reflecting emotional, cognitive, visual, and vestibular functions. All factors were associated with scores on psychological symptom inventories; visual and vestibular factors were also associated with balance performance. There was no significant association between the cognitive factor and neuropsychological performance or between a history of mild traumatic brain injury and factor scores.

CONCLUSION:: Persistent postconcussive symptoms observed months after blast exposure seem to be related to 4 distinct forms of distress, but not to mild traumatic brain injury per se, with vestibular and visual factors possibly related to injury of sensory organs by blast.

Language: en