Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: A review

Abstract

Abstract-Vestibular symptoms are persistent and problematic sequelae of blast exposure. Several lines of evidence suggest that these symptoms often stem from injury to the central nervous system. Current methods of assessing the vestibular system have described vestibular deficits that follow traumatic brain injury and differentiate blunt and blast trauma but have not examined the full range of vestibular functions that depend on the cerebral structures above the midbrain. Damage to the central vestibular circuits can lead to deficits in vital processes of spatial perception and navigation, in addition to dizziness and disequilibrium, and may also affect emotional functioning, particularly noradrenergically modulated states of anxiety. Perceptual functions can be assessed to determine the extent of central nervous system involvement in vestibular symptoms and to provide greater confidence when vestibular dysfunction is to be excluded. The ability to detect central vestibular dysfunction will significantly enhance our response to the dizziness and balance symptoms that are a common source of distress for Veterans.

Quality-of-life for individuals with a vestibular impairment following an acquired brain injury (ABI); the clients’ perspective

“…It is now known that damage to central vestibular circuits can effect emotional functioning, including nor-adrenergically modulated states of anxiety [30]. Rather than suspect that individuals are demonstrating a separate psychological condition, it may be important to consider that, due to the neuroanatomical links between the vestibular and emotional systems, anxiety and vestibular symptoms are quite likely to co-exist [30]. This further supports the need for validation and treatment of the intrinsic vestibular symptoms in parallel with provision of psychosocial support due to the interdependence of these symptoms.…”

Effects of Antioxidant Treatment on Blast-Induced Brain Injury

“…The RC is involved in spatial learning and navigation. Disrupted spatial navigation has previously been documented in rats 2-3 days following blast exposure [85,86] and can persist for months to years after blast exposure in humans [87]. …”

Vestibular Dysfunction after Subconcussive Head Impact

“…18 Although the current experimental protocol only induces 10 soccer headers within the span of 10 min, it is possible that the interaction of visual and vestibular processing is affected at a subtle and transient level during walking that could potentially resemble functional and physiologic changes of a concussive impact.…”

“…Because of its anatomical location in the head, the vestibular system is particularly vulnerable to disruption from head impact, and the disruption in the integration of vestibular processing could be an underlying basis for balance problems after head impact. 18 Estimation of body position/velocity (i.e., self-motion) for postural stability is heavily dependent on the integration of information from multiple sensory modalities including visual, vestibular, and somatosensory (touch, pressure, proprioception). Vestibular input is unique because it provides information relative to motion of the head/body, whereas visual and proprioceptive inputs provide information about body orientation that is relative to the external scene/support surface.…”