Autonomic Dysregulation in Adolescent Concussion Is Sex- and Posture-Dependent

被引：22

作者：

Balestrini, Christopher S. ^{[1
]}

Moir, Marcy Erin ^{[2
]}

Abbott, Kolten C. ^{[2
,3
]}

Klassen, Stephen A. ^{[2
]}

Fischer, Lisa K. ^{[2
]}

Fraser, Douglas D. ^{[2
,3
]}

Shoemaker, Joel Kevin ^{[2
,4
,5
]}

机构：

[1] Schulich Sch Med & Dent, London, ON, Canada

[2] Sch Kinesiol, Fac Hlth Sci, London, ON, Canada

[3] Childrens Hlth Res Inst, London, ON, Canada

[4] Western Univ, Dept Physiol & Pharmacol, London, ON, Canada

[5] Western Univ, Fac Hlth Sci, Sch Kinesiol, 1151 Richmond St, London, ON N6A 3K7, Canada

来源：

CLINICAL JOURNAL OF SPORT MEDICINE | 2021年 / 31卷 / 03期

关键词：

adolescent concussion; heart rate variability; blood pressure; sex differences; autonomic nervous system; sport-related concussion;

D O I：

10.1097/JSM.0000000000000734

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Objective: To study autonomic responses to postural changes in concussed adolescents. The influence of sex was also studied. Design: Longitudinal cohort observational study. Participants: Concussed adolescents (CONC; n = 65; 26 male adolescents; age 15 +/- 1 years, range = 12-18 years) and a control (CTRL) group of nonconcussed adolescents of similar age and sport (CTRL; n = 54; 29 male adolescents; age 14 +/- 1 years, range = 12-18 years). Interventions: Concussed participants were monitored through 6 weekly visits throughout usual physician care. Control participants underwent 2 visits separated by at least 1 week to account for intrapersonal variation in testing measures. Main Outcome Measures: Heart rate variability as the root mean square of successive differences in R-R intervals (RMSSD), heart rate (HR), and blood pressure [mean arterial pressure (MAP) and diastolic blood pressure (DBP)] were measured in supine, sitting, and standing postures. Results: A mixed analysis of variance revealed a group x sex x posture interaction (P = 0.04) where seated values of RMSSD were less in concussed female participants versus control female participants (42 +/- 4 vs 61 +/- 7 ms; P = 0.01; Mann-Whitney rank test). Compared with CTRL, CONC exhibited increased pretesting seated DBP (69 +/- 1 vs 74 +/- 1 mm Hg; P < 0.01), MAP (83 +/- 1 vs 86 +/- 1 mm Hg; P = 0.02), and baseline seated HR (72 +/- 1 vs 77 +/- 2 bpm; P = 0.03). Values of DBP (P = 0.03) and MAP (P < 0.01) improved at clinical discharge, whereas the RMSSD in female participants did not (P > 0.5). Data are mean +/- SEM. Conclusions: A modest reduction in female cardiac autonomic regulation was observed during seated postures. Alterations in seated concussed DBP and MAP, but not RMSSD, resolved at clinical discharge (median = 37 days). The results indicate that, in adolescents, concussion may impair cardiovagal function in a sex-and posture-dependent manner. The findings also suggest that BP metrics, but not RMSSD, are associated with clinical concussion recovery.

引用

页码：257 / 265

页数：9

共 61 条

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PROCEEDINGS OF THE 25TH ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY, VOLS 1-4: A NEW BEGINNING FOR HUMAN HEALTH, 2003, 25 :2424-2427

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