RESUMO
PURPOSE: Dizziness and imbalance are common symptoms during the acute phase of traumatic brain injury (TBI). However, there is evidence to suggest that these symptoms persist into the chronic phase of injury. Few prospective studies have examined the frequency and type of dizziness and imbalance in adults with chronic moderate-severe TBI. The aim of this preliminary analysis was to investigate the prevalence of these symptoms in adults with chronic moderate-severe TBI. METHOD: Twenty-four adults with chronic moderate-severe TBI and a group of 19 age-, sex-, and education-matched noninjured comparison participants were recruited. Self-reported dizziness and imbalance were measured using a modified version of a standard case history form. Significant associations between group (TBI group or noninjured comparison [NC] participants) and self-reports of dizziness, imbalance, and related symptoms (endorsed "yes" or "no") were explored. RESULTS: The TBI group most reported lightheadedness (75%), vertigo (38%), and imbalance and/or falling (46%). The most common related symptom reported by the TBI group was headache (63%) and nausea (46%). Significant associations revealed that the TBI group responded "yes" in higher percentages than the NC group across all categories (dizziness, imbalance, and related symptoms). There were no statistically significant relationships among dizziness, imbalance, or headache symptoms within the TBI group. CONCLUSIONS: These preliminary findings suggest that dizziness and imbalance are prevalent in adults with chronic moderate-severe TBI. Persistent vertiginous symptoms may point to an underlying vestibular impairment. However, further research is needed to characterize vestibular function in chronic moderate-severe TBI.
RESUMO
Noise-induced hearing loss (NIHL) is known to have significant consequences for temporal, spectral, and spatial resolution. However, much remains to be discovered about their underlying pathophysiology. This report extends the recent development of a nonhuman primate model of NIHL to explore its consequences for hearing in noisy environments, and its correlations with the underlying cochlear pathology. Ten macaques (seven with normal-hearing, three with NIHL) were used in studies of masked tone detection in which the temporal or spatial properties of the masker were varied to assess metrics of temporal and spatial processing. Normal-hearing (NH) macaques showed lower tone detection thresholds for sinusoidally amplitude modulated (SAM) broadband noise maskers relative to unmodulated maskers (modulation masking release, MMR). Tone detection thresholds were lowest at low noise modulation frequencies, and increased as modulation frequency increased, until they matched threshold in unmodulated noise. NH macaques also showed lower tone detection thresholds for spatially separated tone and noise relative to co-localized tone and noise (spatial release from masking, SRM). Noise exposure caused permanent threshold shifts that were verified behaviorally and audiologically. In hearing-impaired (HI) macaques, MMR was reduced at tone frequencies above that of the noise exposure. HI macaques also showed degraded SRM, with no SRM observed across all tested tone frequencies. Deficits in MMR correlated with audiometric threshold changes, outer hair cell loss, and synapse loss, while the differences in SRM did not correlate with audiometric changes, or any measure of cochlear pathophysiology. This difference in anatomical-behavioral correlations suggests that while many behavioral deficits may arise from cochlear pathology, only some are predictable from the frequency place of damage in the cochlea.
