Caloric Vestibular Stimulation in Military Traumatic Brain Injury
24 March, 2015
Traumatic brain injury (TBI) external force inflicts a trauma to the brain. TBI is a nationwide public health problem and places a huge burden on society. The estimated the cost of TBI within the U.S. alone during 2010 to be $11.5 billion for direct medical costs and $64.8 billion for indirect costs (e.g. loss of productivity). The prevalence of TBI is likely to be greater in military compared to civilian settings.
In a large-scale survey of two army combat brigades deployed to the Iraq Conflict, approximately 15% of the 2525 respondents had sustained a TBI with either loss of consciousness (10.3%) or altered mental status (4.9%). Studies of other combat brigades have reported higher incidences of 20 to 23%, with mild TBI more prominent than moderate or severe. The condition is associated with a broad range of psychiatric and neurological symptoms, the most common of which are headache, fatigue, sleep disorder, dizziness, amnesia, information processing slowing, executive dysfunction, depression and anxiety. Unfortunately, the effects of TBI are often exacerbated by posttraumatic stress disorder (PTSD), which, in addition to the above symptoms, can feature harrowing flashback, nightmares, phobias, and distressing bodily sensations. Together, these difficulties render service personnel more prone to alcoholism, drug abuse and suicide. TBI has thus far been largely refractory to treatment.
The key aims of the research is to characterise the neurological issues in our veterans and to assess if caloric vestibular stimulation (CVS), a non-invasive neuromodulation technique, can ameliorate those. The conventional method of CVS involves irrigation of the ear canal with warm or cold water. Preliminary studies show that a range of neurological symptoms respond favourably to the technique. The technique has not, however, gained a foothold within rehabilitative practice as it is an impractical procedure which requires recipients to come to the clinic for treatment making it unsuitable for repetitive use .
The proposed study will utilise a novel CVS device that avoids the conventional impracticalities. This device resembles a pair of headphones with two probes which deliver thermal current to the ears and stimulation is self-administered very easily by the patient in the comfort of their own home. If shown to be efficacious, CVS will open the way for significant treatment advances and potentially improve the quality of life for those affected by TBI. Our research has shown benefits in civilian populations who sustained brain injury.
• Emma Denby. Neuropsychologist. Emmadenby.firstname.lastname@example.org
• Laura Smith. Neuropsychologist.email@example.com
• Dr Mohamed Sakel. Director / Consultant Neurorehabilitation. firstname.lastname@example.org
• David Wilkinson. Neuropsychologist. D.T.Wilkinson@kent.ac.uk
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