Factor analysis of persistent postconcussive symptoms within a military sample with blast exposure.
OBJECTIVE
To determine the factor structure of persistent postconcussive syndrome symptoms in a blast-exposed military sample and validate factors against objective and symptom measures.


METHODS
Veterans Affairs medical center and military bases.


METHODS
One hundred eighty-one service members and veterans with at least 1 significant exposure to blast during deployment within the 2 years prior to study enrollment.


METHODS
Confirmatory and exploratory factor analyses of the Rivermead Postconcussion Questionnaire.


METHODS
Rivermead Postconcussion Questionnaire, PTSD (posttraumatic stress disorder) Symptom Checklist-Civilian, Center for Epidemiological Studies Depression scale, Sensory Organization Test, Paced Auditory Serial Addition Test, California Verbal Learning Test, and Delis-Kaplan Executive Function System subtests.


RESULTS
The 3-factor structure of persistent postconcussive syndrome was not confirmed. A 4-factor structure was extracted, and factors were interpreted as reflecting emotional, cognitive, visual, and vestibular functions. All factors were associated with scores on psychological symptom inventories; visual and vestibular factors were also associated with balance performance. There was no significant association between the cognitive factor and neuropsychological performance or between a history of mild traumatic brain injury and factor scores.


CONCLUSIONS
Persistent postconcussive symptoms observed months after blast exposure seem to be related to 4 distinct forms of distress, but not to mild traumatic brain injury per se, with vestibular and visual factors possibly related to injury of sensory organs by blast.
Defense and Veterans Brain Injury Center, Richmond, Virginia (Drs Franke and Walker); Departments of Physical Medicine and Rehabilitation (Drs Franke and Walker) and Biostatistics (Ms Czarnota and Dr Ketchum), School of Medicine, Virginia Commonwealth University, Richmond, Virginia; and The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland (Drs Franke and Walker).
Laura M
LM
Franke
Jenna N
JN
Czarnota
Jessica M
JM
Ketchum
William C
WC
Walker
D000328:Adult; D001753:Blast Injuries / Q000150:complications*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D016273:Occupational Exposure; D038223:Post-Concussion Syndrome / Q000150:complications* / Q000453:epidemiology*; D055815:Young Adult