Prospective Associations Between Traumatic Brain Injury and ... : The Journal of Head Trauma Rehabilitation (original) (raw)

Original Articles

Prospective Associations Between Traumatic Brain Injury and Postdeployment Tinnitus in Active-Duty Marines

Yurgil, Kate A. PhD; Clifford, Royce E. MD, MPH; Risbrough, Victoria B. PhD; Geyer, Mark A. PhD; Huang, Mingxiong PhD; Barkauskas, Donald A. PhD; Vasterling, Jennifer J. PhD; Baker, Dewleen G. MD

Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP; Brenner, Lisa PhD, ABPP

MRS Team

VA San Diego Healthcare System, San Diego, California (Drs Yurgil, Risbrough, Geyer, and Baker); VA Center of Excellence for Stress and Mental Health, San Diego, California (Drs Yurgil, Risbrough, and Baker); Department of Psychological Sciences, Loyola University New Orleans, New Orleans, Louisiana (Dr Yurgil); Naval Medical Center San Diego, San Diego, California (Dr Clifford); Harvard School of Public Health, Boston, Massachusetts (Dr Clifford); Departments of Psychiatry (Drs Risbrough, Geyer, and Baker) and Radiology (Dr Huang), University of California San Diego; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (Dr Barkauskas); VA Boston Healthcare System, Boston, Massachusetts (Dr Vasterling); VA National Center for PTSD, Boston, Massachusetts (Dr Vasterling); and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (Dr Vasterling).

Corresponding Author: Dewleen G. Baker, MD, VA Center for Stress and Mental Health (116A), 3350 La Jolla Village Dr, San Diego, CA 92161 ([email protected]).

This work was supported by VA Health Service Research and Development project no. SDR 09-0128, the Marine Corps, and the Navy Bureau of Medicine and Surgery. The authors acknowledge all MRS coinvestigators, as well as administrative core, of the MRS Team, including logistic coordinators, clinician-interviewers, and data collection staff listed in the Methods article (Baker et al, Prev Chronic Dis. 2012;9(10):E97). The authors also thank the Marine and Navy Corpsmen volunteers for military service and participation in this study.

The authors declare no conflicts of interest.

Abstract

Objective:

To examine whether cause, severity, and frequency of traumatic brain injury (TBI) increase risk of postdeployment tinnitus when accounting for comorbid posttraumatic stress disorder.

Design:

Self-report and clinical assessments were done before and after an “index” deployment to Iraq or Afghanistan.

Setting, Participants, and Measures:

Assessments took place on Marine Corps bases in southern California and the VA San Diego Medical Center. Participants were 1647 active-duty enlisted Marine and Navy servicemen who completed pre- and postdeployment assessments of the Marine Resiliency Study. The main outcome was the presence of tinnitus at 3 months postdeployment.

Results:

Predeployment TBI increased the likelihood of new-onset postdeployment tinnitus (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.28-2.70). Deployment-related TBIs increased the likelihood of postdeployment tinnitus (OR = 2.65; 95% CI, 1.19-5.89). Likelihood of new-onset postdeployment tinnitus was highest for those who were blast-exposed (OR = 2.93; 95% CI, 1.82-6.17), who reported moderate-severe TBI symptoms (OR = 2.22; 95% CI, 1.22-3.40), and who sustained multiple TBIs across study visits (OR = 2.27; 95% CI, 1.44-4.24). Posttraumatic stress disorder had no effect on tinnitus outcome.

Conclusions:

Participants who were blast-exposed, sustained multiple TBIs, and reported moderate-severe TBI symptoms were most at risk for new-onset tinnitus.