Features of postconcussion symptoms recovery after traumatic brain injury among military personnel

Abstract

Traumatic brain injuries due to hostilities inEastern Ukrainein 2017 accounted for 30.8% of all mechanical combat damage and injuries and are an important problem because of postconcussion syndrome manifestation in the long-term period. Purpose – to study the features of postconcussion symptoms recovery among combatants during their rehabilitation in hospital conditions based on electroencephalography and the dynamics of psychophysiological characteristics assessment. Materials and methods. 42 combatants aged 35–45 years who suffered a closed craniocerebral injury during 2017–2018 (more than 3 months after head injury) and 76 healthy men the same age, constituted group II (control), were involved in the study. The study evaluated and analyzed the results of electroencephalography (EEG), manifestations of postconcussion symptoms using К. Cicerone modified special questionnaire as well as the characteristics of attentiveness and short-term memory using a special computer program. Results. Among individuals with postconcussion syndrome, the functioning of non-specific brain systems was found to be impaired making dysregulation changes in the electrical activity of the brain stable and long-lasting. It was shown that the applied rehabilitation programs had a positive effect on the balance and improvement of the brain bioelectrical activity rhythms and, accordingly, the functional activity of these structures (θ and δ characteristics of EEG spectrum improved after rehabilitation (P < 0.05), which may indicate the inclusion of neuro-emotional stress coping mechanisms during rehabilitation in inpatient conditions). Somatic manifestations which very often occur and impair performance, as well as definite complaints from the cognitive sphere, reliably decreased (P < 0.05), but complaints due to sensory functions impairment remained almost unchanged in 17 % of people after the rehabilitation course. The characteristics of attentiveness and short-term memory had a positive (P < 0.001) dynamics after the rehabilitation course and did not exceed the calculated standard indicators. Conclusions. The features of postconcussion symptoms recovery among combatants during their rehabilitation in hospital conditions in terms of θ and δ characteristics of the EEG spectrum have been revealed. The presence of significant (P < 0.001) differences in objective characteristics of cognitive functions in patients before rehabilitation compared with the control group (below standard values), as well as significant (P < 0.001) positive dynamics of attentiveness and short-term memory after rehabilitation of military personnel with postconcussion symptomatology and approximation of these characteristics to standard values have been found. It has been noted that the diagnosis of cognitive disorders associated with traumatic brain injury should be essentially based on the results of neuropsychological objective testing of attentiveness and short-term memory, since they are more dynamic (P < 0.001) indicators compared with complaints relating to cognitive function changes.