Features of functional state restoration among military personnel after traumatic brain injury combined with acubarotrauma

Abstract

Aim – to study the restoration features of postconcussion symptoms and cognitive disorders based on the dynamics of the psychophysiological characteristics of combatants who received brain concussion and acubarotrauma in the acute period.Materials and methods. The study involved 43 members of the armed forces (average total time of stay in a combat zone 15.5 ± 2.0 months) with an average age of 32.0 ± 1.3 years who received a mild traumatic brain injury (concussion) during 2019 and treated at the military mobile hospital (66.7 % of them had acubarotrauma). The manifestations of postconcussion symptoms were evaluated and analyzed using a modified questionnaire by K.Ciceron and the Hospital Anxiety and Depression Scale (HADS).Results. The prevalence of acubarotrauma characteristics has been determined among the wounded servicemen – participants of ATO (JFO) who had been hospitalized with a concussion to the military mobile hospital, and their structural changes after treatment, characterized by a significant improvement in all the studied data – dysfunction of the auditory analyzer, as well as cognitive and affective disorders, anxiety, depression, somatic, sensory disturbances inherent to individuals with a concussion have been assessed. A direct effect of the deployment time in combat zone on such characteristics after treatment of both studied groups as anxiety manifestations (P < 0.01), somatic manifestations (P < 0.001), sensory disturbances (P < 0.01) has been noted. A discriminant model allows to reliably (P < 0.001) determine patterns of informative characteristics of functional state in patients with concussion and those who additionally had acubarotrauma on admission to the hospital.Conclusions. Pathological comorbidity (concussion combined with acubarotrauma) contributes to the predominance of sensory and cognitive impairment manifestations after trauma, was accompanied by a significantly better recovery dynamics of somatic manifestations, sensory impairment and affective reactions due to the approximation of these characteristics to normative values compared with patients that had only a concussion. It has been established that the presence of comorbid pathology before its treatment had a significant effect on sensory and cognitive impairment, dysfunction of the auditory analyzer both prior to and after the treatment and, conversely, anxiety manifestations prior to and after the treatment somatic manifestations and affective reactions after treatment were negatively correlated with the factor of acubarotrauma. The features of the deployment time in the combat zone influence on the post-concussion symptoms manifestations have been revealed. The most informative characteristics allowing to differentiate patients with concussion and those who had acubarotrauma (anxious feeling, neuro-emotional stress, taste or smell changes, vision problems) have been highlighted.