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Characterizing high-velocity angular vestibulo-ocular reflex function in service members post-blast exposure.

Matthew R Scherer1, Mark J Shelhamer, Michael C Schubert

  • 1Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA.

Experimental Brain Research
|November 30, 2010
PubMed
Summary

Service members with blast-related traumatic brain injury (TBI) and dizziness show altered vestibular function. Symptoms worsen with exertion, indicating vestibular system pathology in blast-exposed individuals.

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Area of Science:

  • Neuroscience
  • Vestibular System Research
  • Military Medicine

Background:

  • Blasts are a common cause of injury in modern warfare.
  • Traumatic brain injury (TBI) and dizziness are frequent consequences of blast exposure.
  • Service members often report exacerbated symptoms with physical activity.

Purpose of the Study:

  • To quantify angular vestibulo-ocular reflex gain (aVOR) in blast-exposed service members with TBI.
  • To assess symptom changes during exertion in this population.
  • To investigate the relationship between dizziness, TBI, and vestibular function.

Main Methods:

  • Prospective study of 24 service members recovering from TBI, divided into symptomatic and asymptomatic groups.
  • Utilized wireless monocular scleral search coils and rate sensors for head and eye rotation measurements.
  • Assessed symptoms using Visual Analog Scale (VAS) during high-intensity activities like fast walking/running.

Main Results:

  • Symptomatic group showed significantly lower active yaw aVOR gain compared to asymptomatic.
  • Both active and passive pitch aVOR gains were reduced in the symptomatic group.
  • Peak symptom severity occurred during exertional testing, with some individuals exhibiting elevated aVOR gain.

Conclusions:

  • Blast-exposed service members with TBI and dizziness exhibit varied aVOR gain, suggesting vestibular system pathology.
  • Potential injury sites include vestibular efference pathways, vestibular hair cells, or afferent pathways.
  • Reduced pitch aVOR and increased symptoms during exertion align with previous findings in blast-exposed personnel.