Baseline EEG abnormalities in mild traumatic brain injury from the BIMA study.

Abstract

The Brain Injury and Mechanisms of Action of HBO₂ for Persistent Post-Concussive Symptoms after Mild Traumatic Brain Injury (BIMA), sponsored by the Department of Defense, is a randomized, double-blind, sham-controlled trial of hyperbaric oxygen (HBO₂) in service members with persistent post-concussive symptoms following mild TBI, undergoing comprehensive assessments. The clinical EEG was assessed by neurologists for slow wave activity, ictal/interictal epileptiform abnormalities, and background periodic discharges. There is scant literature about EEG findings in this population, so we report baseline clinical EEG results and explore associations with other evaluations, including demographics, medication, neurological assessments, and clinical MRI outcomes. Seventy-one participants were enrolled: median age 32 years, 99% male, 49% comorbid PTSD, 28% with mTBI in the previous year, 32% blast injuries only, and 73% multiple injuries. All participants reported medication use (mean medications = 8, SD = 5). Slowing was present in 39%: generalized 37%, localized 8%, both 6%. No other abnormalities were identified. Slowing was not significantly associated with demographics, medication or neurological evaluation. Participants without EEG abnormalities paradoxically had significantly higher number of white matter hyperintensities as identified on MRI (p = 0.003). EEG slowing is present in more than one-third of participants in this study without evidence of associations with demographics, medications or neurological findings.

TRIAL REGISTRATION:

ClinicalTrials.gov Identifier: NCT01611194; https://clinicaltrials.gov/show/NCT01611194.

• Authors: Christopher S Williams, Mark C Spitz, John F Foley, Lindell K Weaver, Anne S Lindblad, Michael R Wierzbicki
• Journal: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc (Undersea Hyperb Med) 2016 Aug-Sept Vol. 43 Issue 5 Pg. 521-530 ISSN: 1066-2936 [Print] United States
• PMID: 28768071 (Publication Type: Clinical Trial, Phase II, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright© Undersea and Hyperbaric Medical Society.

Topics

• Adult
• Blast Injuries (complications)
• Brain Concussion (complications)
• Double-Blind Method
• Electroencephalography
• Female
• Humans
• Hyperbaric Oxygenation
• Magnetic Resonance Imaging
• Male
• Military Personnel
• Post-Concussion Syndrome (diagnosis, etiology, physiopathology, therapy)
• Stress Disorders, Post-Traumatic (etiology)