Respiratory Sinus Arrhythmia Correlates With Depressive Symptoms Following Mild Traumatic Brain Injury

Abstract

Abstract. Depression is a pervasive psychiatric problem following mild traumatic brain injury (mTBI). However, the onset and course of symptom expression following mTBI can differ from that of spontaneous episodes of depression. Here, we aimed to assess a physiological metric closely linked to depression: respiratory sinus arrhythmia (RSA), a measure of high frequency heart rate variability. RSA is reduced during depressive episodes, and higher resting RSA has been shown to predict future recovery from depression. In this study, we investigated if these patterns were observed throughout the typical timeframe of sub-acute mTBI recovery. Although RSA did not differ between mTBI ( n = 50) and control ( n = 27) groups, depressive symptoms were reliably correlated with RSA only in the mTBI group. This pattern was consistent 2 weeks, 2 months, and 4 months post-injury. Furthermore, resting RSA shortly following injury predicted the trajectory of depressive symptoms 2 months later. These findings generalize the connection between RSA and depression to a clinical population where depressive symptoms are common but often difficult to parse from other post-trauma consequences.

Predictive Value of Subacute Heart Rate Variability for Determining Outcome Following Adolescent Concussion

“…Moreover, a greater HR dispersion at rest and during stress predicted a poorer cognitive performance on the GMR and ONB tasks at the post-acute evaluation. These findings corroborate those of Brandt and colleagues, who identified RSA indices as potential predictors of adverse mTBI outcomes [ 64 ].…”

Autonomic dysfunction in adults following mild traumatic brain injury: A systematic review

“…Of the included studies, twenty-one were crosssectional studies (Abaji et al, 2016;Bishop et al, 2017;Ding et al, 2020;Dobney et al, 2018;Hanna-Pladdy et al 2001;Hilz et al, 2011Hilz et al, , 2015Hilz et al, , 2016Hilz et al, , 2017Hilz et al, , 2020Howard et al, 2018;Huang et al, 2019;Johnson et al, 2018Johnson et al, , 2020Kozlowski et al, 2013;Mirow et al, 2016;Pyndiura et al, 2020;Russell et al, 2020;Solbakk et al, 2005;Tan et al, 2009;Truong & Ciuffredia, 2016), sixteen were cohort studies (Brandt et al, 2020;Clausen et al, 2016;Dobson et al, 2017;Gall et al, 2004;La Fountaine et al, 2009Leddy et al, 2010;Liao et al, 2016;Purkayastha, Williams et al, 2019;Senthinathan et al, 2017;Wright et al 2017Wright et al , 2018, while two (Haider et al, 2020;Hutchison et al, 2017) were case-control studies. All studies, with the exception of two (Leddy et al, 2010;Mirow et al, 2016), compared mTBI participants to nonhead injured control groups.…”

“…In twenty-two studies (Abaji et al, 2016;Bishop et al, 2017;Ding et al, 2020;Dobney et al, 2018;Haider et al, 2020;Hanna-Pladdy et al, 2001;Hilz et al, 2011Hilz et al, , 2015Hilz et al, , 2016Hilz et al, , 2017Hilz et al, , 2020Howard et al, 2018;Huang et al, 2019;Johnson et al, 2018Johnson et al, , 2020Kozlowski et al, 2013;Mirow et al, 2016;Pyndiura et al, 2020;Russell et al, 2020;Solbakk et al, 2005;Tan et al, 2009;Truong & Ciuffreda, 2016) autonomic dysfunction was assessed at a single timepoint (within 72 hours to greater than 10 years post-injury). Multiple assessments were conducted in fifteen studies (Brandt et al, 2020;Dobson et al, 2017;Gall Fig. 1.…”

“…Two studies (Dobney et al, 2018;Truong & Ciuffreda, 2016) did not specify the sex/gender of mTBI participants; one study (Truong & Ciuffreda, 2016) did not include sex/gender of mTBI or control participants. Twenty studies (Brandt et al, 2020;Dobney et al, 2018;Dobson et al, 2017;Haider et al, 2020;Hanna-Pladdy et al, 2001;Hilz et al, 2011Hilz et al, , 2015Hilz et al, , 2016Hilz et al, , 2017Howard et al, 2018;Huang et al, 2019;Hutchison et al, 2017;Johnson et al, 2018Johnson et al, , 2020Kozlowski et al, 2013;La Fountaine et al, 2011;Pyndiura et al 2020;Russell et al, 2020;Senthinathan et al, 2017;Solbakk et al, 2005) reported participant sex and eight studies (Hilz et al, 2020;La Fountaine et al, 2009Leddy et al, 2010;Liao et al, 2016;Mirow et al, 2016;Tan et al, 2009) reported participant gender. Ten studies (Abaji et al, 2016;Bishop et al, 2017;Clausen et al, 2016;Ding et al, 2020;Gall et al, 2004;La Fountaine et al, 2018;Purkayastha, Williams et al, 2019;Wright et al, 2017Wright et al, , 2018 did not specify if reporting sex/gender or interchanged the two terms.…”

“…Time since injury varied greatly between studies, with nine studies assessing participants within 72 hours of mTBI (Bishop et al, 2017;Dobson et al, 2017;Gall et al, 2004;La Fountaine et al 2009Russell et al, 2020;Wright et al, 2017Wright et al, , 2018, nine studies within the first 7 days (Huang et al, 2019;Hutchison et al, 2017;Johnson et al, 2020;La Fountaine et al, 2011;Liao et al, 2016;Purkayastha, Williams et al, 2019;Senthinathan et al, 2017;, one within 10 days (Johnson et al, 2018), one within the first 2 weeks (Brandt et al, 2020) and the remaining seventeen studies (Abaji et al, 2016;Clausen et al, 2016;Ding et al, 2020;Haider et al, 2020;Hanna-Pladdy et al, 2001;Hilz et al, 2011Hilz et al, , 2015Hilz et al, , 2016Hilz et al, , 2017Hilz et al, , 2020Howard et al, 2018;Kozlowski et al, 2013;Leddy et al, 2010;Mirow et al, 2016;Pyndiura et al, 2020;Solbakk et al, 2005;Truong & Ciuffreda, 2016) ranged from > 45 days to > 10 years post-mTBI. Time since injury was not reported in two studies (Dobney et al, 2018;Tan et al, 2009).…”