Laura M Franke1, Jenna N Czarnota, Jessica M Ketchum, William C Walker. 1. 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).
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.
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.
Authors: Mark Meterko; Errol Baker; Kelly L Stolzmann; Ann M Hendricks; Keith D Cicerone; Henry L Lew Journal: J Head Trauma Rehabil Date: 2012 Jan-Feb Impact factor: 2.710
Authors: William C Walker; Scott D McDonald; Jessica M Ketchum; Michelle Nichols; David X Cifu Journal: J Head Trauma Rehabil Date: 2013 Jan-Feb Impact factor: 2.710
Authors: Lindsay D Nelson; Mark D Kramer; Christopher J Patrick; Michael A McCrea Journal: J Int Neuropsychol Soc Date: 2018-08-06 Impact factor: 2.892
Authors: Kody R Campbell; Robert J Peterka; Peter C Fino; Lucy Parrington; Jennifer L Wilhelm; Natalie C Pettigrew; Laurie A King Journal: Front Neurol Date: 2022-10-04 Impact factor: 4.086