Factors Associated With Outcomes in Patients With Vestibular Symptoms Related to Traumatic Brain Injury
Abstract
This study is part of a research program that has as a long-term goal to better manage Veterans suffering from dizziness and imbalance related to a head injury (concussion) and/or blast exposure. Dizziness and imbalance are common symptoms following head injury that can continue for months or years in some individuals. Chronic dizziness is a serious health concern that can lead to increased fall risk, emotional and psychological distress, as well as work disability. There are multiple obstacles to the management of post-concussion dizziness. First, the diagnosis of dizziness and/or balance problems (imbalance) is complex because the ability to maintain balance involves input from multiple sensory systems, including the inner ear balance system, vision, the sense of touch, and integration of these inputs by the central nervous system. Damage to any one of these systems can cause a sensation of dizziness or imbalance, and treatment may be based on the location of the damage. Thus, multiple causes of post-concussive dizziness can present a challenge to diagnosis, and obstacle to treatment. Second, war-related concussion can cause other symptoms such as post-traumatic stress, anxiety, and headaches that can worsen the impact of the dizziness or imbalance. Third, some medications prescribed for other post-concussion symptoms can cause dizziness, and medication for dizziness can negatively impact long-term recovery. Veterans who experience symptoms of military-related concussion or blast injuries often undergo testing at Department of Veterans Affairs (VA) Medical Centers to determine the presence and severity of post-concussion symptoms such as dizziness/imbalance. The VA and Department and Defense (DoD) developed clinical practice guidelines that outline recommendations for managing individuals with post-concussive dizziness, but it is unclear how these recommendations impact treatment for post-concussion dizziness/imbalance. In addition, some Veterans may seek care outside the VA or use alternative approaches (yoga, for example) to manage their post-concussive dizziness. The purpose of this study is to determine factors that contribute to successful outcomes of patients with concussion/blast-related dizziness. We will use VA and DoD health databases to identify and examine characteristics of Veterans with specific (for example, inner ear balance dysfunction) and non-specific diagnoses of post-concussion dizziness. Then, we will survey Veterans using questionnaires and access the VA electronic medical records to determine factors that impact long-term recovery of post-concussion dizziness. Specifically, we will examine the impact of factors such as type of treatment, the presence or absence of health conditions such as headache and anxiety, the severity of head injury, and age and gender. This project will provide the DoD and VA with important information to improve management of individuals with dizziness and imbalance associated with concussion and blast injuries. To date, there are no data on the clinical management pathways and outcomes of Veterans with concussion who indicate significant dizziness and/or imbalance on the initial VA evaluation for military-related concussion. By understanding factors that impact outcomes, we may be better able to customize rehabilitation approaches and facilitate return to duty for active duty Service members suffering from post-concussion dizziness.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710691
Entities
People
- Faith Akin
Organizations
- Mountain Home VA Medical Center
- United States Army