Article

This was an observational study of a cohort of 63 Operation Iraqi
Freedom/Operation Enduring Freedom veterans with mild traumatic brain injury
(mTBI) associated with an explosion. They had headaches, residual neurological
deficits (NDs) on neurological examination, and posttraumatic stress disorder
(PTSD) and were seen on average 2.5 years after their last mTBI. We treated them
with sleep hygiene counseling and oral prazosin. We monitored headache severity,
daytime sleepiness using the Epworth Sleepiness Scale, cognitive performance
using the Montreal Cognitive Assessment test, and the presence of NDs. We
quantitatively measured olfaction and assessed PTSD severity using the PTSD
Checklist-Military Version. Nine weeks after starting sleep counseling and
bedtime prazosin, the veterans' headache severity decreased, cognitive function
as assayed with a brief screening tool improved, and daytime sleepiness
diminished. Six months after completing treatment, the veterans demonstrated
additional improvement in headache severity and daytime sleepiness and their
improvements in cognitive function persisted. There were no changes in the
prevalence of NDs or olfaction scores. Clinical improvements correlated with
reduced PTSD severity and daytime sleepiness. The data suggested that reduced
clinical manifestations following mTBI correlated with PTSD severity and
improvement in sleep, but not the presence of NDs or olfaction impairment.

Langue : ANGLAIS