Vestibular Consequences of Blast-related Mild Traumatic Brain Injury

项目摘要/摘要 该项目的目标是确定轻度创伤性脑损伤的影响。 (MTBI)和前庭系统和中枢神经系统的冲击波暴露。头晕和平衡 障碍是与mTBI或头部损伤相关的常见症状。数不胜数 研究已经提供了重要的证据表明mtbi或头部损伤会造成损害。 前庭系统；然而，大多数人将前庭评估限制在 水平半规管功能的评估。最近，方法已经被 用于评估耳石功能，有一些证据表明，头部损伤可能 对耳石器官的影响大于对半规管的影响。 MTBI被称为退伍军人手术归来的标志性病情 持久自由/伊拉克自由行动(OEF/OIF)，其原因往往与 简易爆炸装置、迫击炮或火箭推进装置的爆炸暴露 手榴弹。一些研究人员推测，头晕和平衡障碍 冲击波暴露后与颅脑损伤造成的中枢神经系统损害有关，而不是 爆炸伤产生的压力波。因此，大多数研究都集中在前庭。 颅脑损伤(或头部损伤)的后果，关于爆炸影响的数据有限 暴露在前庭功能或平衡上。最近，磁共振成像 已经开发了一些技术，这些技术可能允许测试以下假设 与头部损伤或冲击波暴露有关的头晕或失衡的症状通常是 由于中央前庭或中枢神经系统受累。 该项目的具体目标是确定mTBI和爆炸暴露的影响。 关于(1)外周前庭系统功能(特别是水平半规管 功能，耳石器官功能)，(2)中央前庭/中枢神经系统功能，(3)姿势 稳定性，以及(4)与头晕相关的生活质量。四个科目组别将包括 退伍军人抱怨头晕/不平衡，(1)有爆炸暴露史，(2)有 MTBI组，(3)冲击暴露+mTBI组，(4)对照组。每个科目都将 接受水平半规管功能测试(卡路里和转椅)，测试 耳石功能(前庭诱发肌源性电位，主观视觉垂直)，中央 前庭功能/中枢神经系统功能(眼球运动测试、扩散张量和敏感度 体重成像)，步态和平衡测试，以及头晕残疾清单。

Project Summary/Abstract The goal of this project is to determine the effects of mild traumatic brain injury (mTBI) and blast exposure on the vestibular system and CNS. Dizziness and balance disorders are common symptoms associated with mTBI or head injury. Numerous studies have provided significant evidence that mTBI or head injury can cause damage to the vestibular system; however, most have limited the vestibular evaluation to assessment of horizontal semicircular canal function. Recently, methods have been developed to assess otolith function, and there is some evidence that head injury may affect the otolith organs to a greater degree than the semicircular canals. mTBI has been called the signature condition of veterans returning from Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF), and the cause is often related to blast exposure from improvised explosive devices, mortars or rocket-propelled grenades. Some investigators have presumed that dizziness and balance disorders following blast exposure are related to CNS damage caused by the TBI rather than the pressure wave from the blast injury. Thus, most research has focused on the vestibular consequences of TBI (or head injury), and there is limited data on the effects of blast exposure on vestibular function or balance. Recently, magnetic resonance imaging techniques have been developed that may allow for testing the assumption that the symptoms of dizziness or imbalance related to head injury or blast exposure are often due to central vestibular or CNS involvement. Specific aims of this project are to determine the effect of mTBI and blast exposure on (1) peripheral vestibular system function (specifically, horizontal semicircular canal function, and otolith organ function), (2) central vestibular/CNS function, (3) postural stability, and (4) dizziness-related quality of life. Four subject groups will include veterans complaining of dizziness/imbalance with (1) a history of blast exposure, (2) with mTBI, (3) with blast exposure and mTBI, and (4) a control group. Each subject will undergo tests of horizontal semicircular canal function (caloric and rotary chair), tests of otolith function (vestibular evoked myogenic potentials, subjective visual vertical), central vestibular function/CNS function (ocular motor tests, diffusion tensor and susceptibility weighting imaging), gait and balance testing, and the Dizziness Handicap Inventory.