The Military Injuries: Understanding Post-Traumatic Epilepsy Study: Understanding Relationships among Lifetime Traumatic Brain Injury History, Epilepsy, and Quality of Life.

Autor: Pugh MJ; VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.; Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA., Kennedy E; Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA., Gugger JJ; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Mayo J; Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA., Tate D; VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.; Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA., Swan A; Department of Psychology, University of Texas San Antonio, San Antonio, Texas, USA., Kean J; VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.; Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA., Altalib H; Epilepsy Center of Excellence VA Connecticut Health Care System, West Haven, Connecticut, USA; Departments of Neurology and Psychiatry, Yale University School of Medicine, West Haven, Connecticut, USA., Gowda S; Department of Neurology, Baylor School of Medicine, Houston, Texas, USA., Towne A; Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA; Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA., Hinds S; Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA., Van Cott A; VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA; Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA., Lopez MR; Miami VA Health Care System, Miami, Florida, USA; Department of Neurology, University of Miami School of Medicine, Miami, Florida, USA., Jaramillo CA; Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, San Antonio, Texas, USA., Eapen BC; VA Greater Los Angeles Healthcare System, Los Angeles, California, USA; University of California Los Angeles, Los Angeles, California, USA., McCafferty RR; Desert Regional Medical Center, Palm Springs, California, USA., Salinsky M; VA Portland Healthcare System, Portland, Oregon, USA; Oregon Health & Sciences University, Portland, Oregon, USA., Cramer J; Department of Neurology, Baylor School of Medicine, Houston, Texas, USA.; Cramer Consulting, Houston, Texas, USA., McMillan KK; Behavioral Science Consulting, San Antonio, Texas, USA., Kalvesmaki A; VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.; Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA., Diaz-Arrastia R; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Journal of neurotrauma [J Neurotrauma] 2021 Oct 15; Vol. 38 (20), pp. 2841-2850.
DOI: 10.1089/neu.2021.0015
Abstrakt: Understanding risk for epilepsy among persons who sustain a mild (mTBI) traumatic brain injury (TBI) is crucial for effective intervention and prevention. However, mTBI is frequently undocumented or poorly documented in health records. Further, health records are non-continuous, such as when persons move through health systems (e.g., from Department of Defense to Veterans Affairs [VA] or between jobs in the civilian sector), making population-based assessments of this relationship challenging. Here, we introduce the MINUTE (Military INjuries-Understanding post-Traumatic Epilepsy) study, which integrates data from the Veterans Health Administration with self-report survey data for post-9/11 veterans ( n  = 2603) with histories of TBI, epilepsy and controls without a history of TBI or epilepsy. This article describes the MINUTE study design, implementation, hypotheses, and initial results across four groups of interest for neurotrauma: 1) control; 2) epilepsy; 3) TBI; and 4) post-traumatic epilepsy (PTE). Using combined survey and health record data, we test hypotheses examining lifetime history of TBI and the differential impacts of TBI, epilepsy, and PTE on quality of life. The MINUTE study revealed high rates of undocumented lifetime TBIs among veterans with epilepsy who had no evidence of TBI in VA medical records. Further, worse physical functioning and health-related quality of life were found for persons with epilepsy + TBI compared to those with either epilepsy or TBI alone. This effect was not fully explained by TBI severity. These insights provide valuable opportunities to optimize the resilience, delivery of health services, and community reintegration of veterans with TBI and complex comorbidity.
Databáze: MEDLINE