Heart Rate Variability during Face Cooling in Concussed Adolescents

Haider, Mohammad Nadir; Wilber, Charles G.; Viera, Kaitlin B.; Bezherano, Itai; Leddy, John J.

doi:10.1212/01.wnl.0000580900.09715.8d

Cited by 2 publications

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“…Participants without a history of concussion demonstrated the typical increase in RMSSD from baseline in response to stimulation of the trigeminal nerve with ice water, which is an indirect measure of cardiac parasympathetic activity (28). Participants who reported having a concussion more than a year ago, however, had a blunted response during the first 2 min of FC that was equivalent to the response we found in acutely (<10 days since injury) concussed college (14) and high school (19) athletes in previous studies. Heart rate in CH group increased from baseline to the end of minute 1 during FC, which is the opposite of the reduction in HR typically seen with cold stimulation of the trigeminal nerve.…”

Section: Discussionsupporting

confidence: 57%

“…Participants in both groups had been recruited as healthy controls in previous studies (14,19). CH were healthy male and female high school or college-aged athletes with a remote history of a concussion that occurred more than 1 year ago.…”

Section: Participantsmentioning

confidence: 99%

“…Hence, the purpose of this study was to determine the parasympathetic response to FC in asymptomatic student athletes with a remote history of concussion. For this, we retrospectively identified healthy student athletes who were initially recruited as healthy controls in previous studies (14,19). The inclusion criteria for healthy controls in those studies included (1) not experiencing a concussion within the past year and (2) no more than 3 lifetime concussions.…”

Section: Introductionmentioning

confidence: 99%

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Blunted Cardiac Parasympathetic Activation in Student Athletes With a Remote History of Concussion: A Pilot Study

et al. 2020

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Introduction: Blunted cardiac autonomic nervous system (ANS) responses, quantified using heart rate variability (HRV), have been reported after sport-related concussion (SRC). Research suggests this persists beyond clinical recovery. This study compared cardiac parasympathetic responses in student athletes with a remote history of SRC (> 1-year ago, Concussion History: CH) with those who reported no lifetime history of SRC (Concussion Naïve: CN). Design: Retrospective nested case-control. Setting: University laboratory. Patients or Other Participants: CH (n = 9, 18.3 ± 2 years, 44% male, median 2 years since injury) were student athletes with a remote history of concussion(s) from more than 1 year ago. CN (n = 21, 16.7 ± 3 years, 67% male) were student athletes with no lifetime history of concussion. Exclusion criteria included taking medications that could affect ANS function, history of concussion within the past year, persistent concussion symptoms, lifetime history of moderate to severe brain injury, and lifetime history of more than 3 concussions. Material and Methods: Participants performed the Face Cooling (FC) test for 3-min after 10-min of supine rest while wearing a 3-lead electrocardiogram in a controlled environment. Outcome Measures: Heart rate (HR), R-R interval (RRI), root mean square of the successive differences (RMSSD) of RRI, high frequency (HF) and low frequency to HF (LF:HF) ratios. Haider et al. Persistent ANS Dysfunction After Concussion Results: At baseline, CH had a lower resting HR than CN (62.3 ± 11 bpm vs. 72.9 ± 12, p = 0.034). CH had a different HR response to FC than CN (+8.9% change from baseline in CH vs. −7.5% in CN, p = 0.010). CH also had a smaller RMSSD increase to FC than CN (+31.8% change from baseline in CH vs. +121.8% in CN, p = 0.048). There were no significant group differences over time in RRI (p = 0.106), HF (p = 0.550) or LF:HF ratio (p = 0.053). Conclusion: Asymptomatic student athletes with a remote history of concussion had a blunted cardiac parasympathetic response to FC when compared with athletes with no lifetime history of concussion. These data suggest that an impaired autonomic response to a physiological stressor persists after clinical recovery from SRC for longer than previously reported.

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Section: Discussionsupporting

confidence: 57%

Section: Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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