Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review

Abstract

BACKGROUND:Recent evidence suggests that autonomic nervous dysfunction may be one of many potential factors contributing to persisting post-concussion symptoms.OBJECTIVE:This is the first systematic review to explore the impact of concussion on multiple aspects of autonomic nervous system functioning.METHODS:The methods employed are in compliance with the American Academy of Neurology (AAN) and PRISMA standards. Embase, MEDLINE, PsychINFO, and Science Citation Index literature searches were performed using relevant indexing terms for articles published prior to the end of December 2016. Data extraction was performed by two independent groups, including study quality indicators to determine potential risk for bias according to the 4-tiered classification scheme of the AAN.RESULTS:Thirty-six articles qualified for inclusion in the analysis. Only three studies (one Class II and two Class IV) did not identify anomalies in measures of ANS functioning in concussed populations.CONCLUSIONS:The evidence supports the conclusion that it is likely that concussion causes autonomic nervous system anomalies. An awareness of this relationship increases our understanding of the physical impact of concussion, partially explains the overlap of concussion symptoms with other medical conditions, presents opportunities for further research, and has the potential to powerfully inform treatment decisions.

Rapid resolution of concussion related symptoms in an 11‐month‐old male with integrative medicine assessment and treatment: Case report

“…There were no side effects and the patient has remained free of concussion related symptoms for the past 8 years. The ART testing was consistent with the presence of an IF in the head which is consistent with current thinking about the pathophysiology of concussions . The ART testing was consistent with a brain localization IF as a result of the patient's head trauma with consequent increased irritability, crying, and lack of full, alert eye contact.…”

“…Irritability and visual system changes can present in the context of concussion . The autonomic nervous system and neuronal depolarization appear to be involved in concussion pathophysiology …”

“…1,2,4,5 The autonomic nervous system and neuronal depolarization appear to be involved in concussion pathophysiology. 4,6 We present a case of an 11-month-old male with a clinical diagnosis of concussion related symptoms who had a rapid dramatic response after integrative medicine assessment and treatment. The assessment technique of autonomic response testing (ART) was followed by the integrative medicine treatment method known as neural therapy (NT).…”

Change in Heart Rate Variability after Concussion in a Collegiate Soccer Player

“…Autonomic nervous system (ANS) dysfunction has been recognized as a marker of post-concussion syndrome. 2 In recent literature, disruption of heart rate variability (HRV) has been shown to be a measurable aspect of this dysfunction. 3,4 Although these studies have shown a disruption in HRV, 5 no study to date has continuously monitored HRV in athletes pre-and post-SRC.…”

An active approach in the treatment of post-concussion syndrome - Evidence-based practice in a collective case study

“…One of the major challenges in dealing with PCS is categorizing the underlying pathologies and understanding their effect on the symptomatology, to which the evidence suggests a multitude of neurophysiological and psychosomatic mechanisms. These mechanisms include disruptions in cerebral blood flow (CBF), 23,24 changes in brain metabolism, 25 axon damage, 26 changes in autonomic and neuroendocrine function, [27][28][29][30] cervical injury and postural weakness, 31 disturbances in the vestibular and oculomotor system, 32,33 and neuropsychological dysfunctions. 34,35 These myriad of components and overlapping comorbidities adds to the complexity of PCS, and highlights the difficulties of having a single treatment regimen.…”