Association of Traumatic Brain Injury with Vestibular Dysfunction and Dizziness in Post-9/11 Veterans

Alicia A. Swan, Jeremy T. Nelson, Terri K. Pogoda, Faith W. Akin, Kristal M. Riska, Courtney D. Hall, Megan E. Amuan, Kristine Yaffe, Mary Jo Pugh

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objective: To describe the prevalence and impact of vestibular dysfunction and nonspecific dizziness diagnoses and explore their associations with traumatic brain injury (TBI) severity, mechanism, and postconcussive comorbidities among post-9/11 veterans. Setting: Administrative medical record data from the US Departments of Defense and Veterans Affairs (VA). Participants: Post-9/11 veterans with at least 3 years of VA care. Design: Cross-sectional, retrospective, observational study. Main Measures: International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for TBI, vestibular dysfunction, dizziness, and other commonly associated postconcussive conditions; Neurobehavioral Symptom Inventory. Results: Of the 570 248 post-9/11 veterans in this sample, 0.45% had a diagnosis of vestibular dysfunction and 2.57% had nonspecific dizziness. Those with either condition were more likely to have evidence of TBI (57.11% vs 28.51%) and reported more disruption from neurobehavioral symptoms. Blast and nonblast injuries were associated with greater symptom disruption, particularly in combination. Conclusions: There was a consistent, significant association between TBI and vestibular dysfunction or nonspecific dizziness, after controlling for sociodemographic factors, injury mechanism, and comorbid conditions. Given that most deployed post-9/11 veterans report blast and/or nonblast injuries, the need for prompt identification and management of these conditions and symptoms is clear.

Original languageEnglish (US)
JournalJournal of Head Trauma Rehabilitation
DOIs
StateAccepted/In press - 2019
Externally publishedYes

Keywords

  • brain injuries
  • dizziness
  • prevalence
  • traumatic
  • vestibular diseases
  • veteran health
  • veterans

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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    Swan, A. A., Nelson, J. T., Pogoda, T. K., Akin, F. W., Riska, K. M., Hall, C. D., Amuan, M. E., Yaffe, K., & Pugh, M. J. (Accepted/In press). Association of Traumatic Brain Injury with Vestibular Dysfunction and Dizziness in Post-9/11 Veterans. Journal of Head Trauma Rehabilitation. https://doi.org/10.1097/HTR.0000000000000513