Pain and chronic mild traumatic brain injury in the US military population: a Chronic Effects of Neurotrauma Consortium study
Pain and chronic mild traumatic brain injury in the US military population: a Chronic Effects of Neurotrauma Consortium study
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DOI：
10.1080/02699052.2018.1482427
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发表时间：
2018-01-01
期刊：
影响因子：
1.9
通讯作者：
Pugh, N. L.
中科院分区：
文献类型：
--
作者：
Hoot, Michelle R.;Levin, Harvey S.;Pugh, N. L.
主要目标：描述轻度创伤性脑损伤 (mTBI) 与疼痛强度和疼痛干扰结果之间的关联，同时考虑潜在的混杂因素和中介因素，包括伊拉克和阿富汗战争美国退伍军人队列中的环境因素和合并症。研究设计：来自前瞻性纵向研究的基线数据的横截面快照。方法：在有或没有暴露于 mTBI 的参与者之间比较 mTBI 对疼痛强度和疼痛干扰的影响。使用协变量调整回归分析以及结构方程建模（SEM）方法对数据进行分析，以评估不同建模假设下研究结果的稳健性。由于两种方法的结果在 mTBI 暴露与疼痛之间的总体关联方面是一致的，因此结果主要集中在 SEM 结果上。结果：mTBI 暴露组报告的创伤后应激障碍 (PTSD)、抑郁、焦虑和睡眠障碍指数显着更高。考虑其他因素后，mTBI 暴露与疼痛干扰和疼痛强度结果显着但间接相关。结论：在该样本中，mTBI 与疼痛强度和疼痛干扰密切相关。然而，这种影响似乎是由其他常见的 mTBI 合并症介导的：创伤后应激障碍 (PTSD)、抑郁、焦虑和睡眠障碍。
Primary objectives: To describe the association between mild traumatic brain injury (mTBI) and pain intensity and pain interference outcomes while accounting for potential confounders and mediators including environmental factors and comorbidities in a cohort of US Veterans of the Iraq and Afghanistan wars.Research design:Cross-sectional snapshot of baseline data from a prospective, longitudinal study.Methods: Effects of mTBI on pain intensity and pain interference were compared between participants with or without mTBI exposure. Data were analysed using covariate-adjusted regression analyses as well as structural equation modelling (SEM) methods to assess the robustness of findings across different modelling assumptions. As results of the two approaches were consistent with respect to the overall association between mTBI exposure and pain, the results focus primarily on the SEM findings.Results: The mTBI exposed group reported significantly greater indices of post-traumatic stress disorder (PTSD), depression, anxiety and sleep disturbance. After accounting for other factors, mTBI exposure was significantly, but indirectly associated with the pain interference and pain intensity outcomes.Conclusions: mTBI is strongly associated with pain intensity and pain interference in this sample. However, the effect appears to be mediated by other common mTBI comorbidities: PTSD, depression, anxiety and sleep disturbance.