Cerebral Blood Flow During Treadmill Exercise Is a Marker of Physiological Postconcussion Syndrome in Female Athletes

被引:107
作者
Clausen, Mary [1 ]
Pendergast, David R. [1 ]
Willer, Barry [3 ]
Leddy, John [2 ]
机构
[1] SUNY Buffalo, Ctr Res & Educ Special Environm, Dept Physiol, Buffalo, NY USA
[2] SUNY Buffalo, Univ Sports Med, Orthopaed, 160 Farber Hall, Buffalo, NY 14214 USA
[3] SUNY Buffalo, Dept Psychiat, Buffalo, NY 14214 USA
关键词
carbon dioxide sensitivity; cerebral blood flow; exercise; postconcussion syndrome; ventilation; HEART-RATE-VARIABILITY; SPORTS-RELATED CONCUSSION; DYNAMIC EXERCISE; CARBON-DIOXIDE; VENTILATORY RESPONSE; BRAIN-INJURY; VELOCITY; AUTOREGULATION; HUMANS; CO2;
D O I
10.1097/HTR.0000000000000145
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: Some patients with postconcussion syndrome (PCS) have reduced exercise capacity that may reflect altered central cardiorespiratory control. The purpose of this study was to evaluate control of cerebral blood flow (CBF) during exercise in females with PCS. Setting: University Concussion Clinic. Participants: Nine female Division 1 collegiate team athletes with PCS (23 +/- 6 years) and a reference group of 13 healthy female recreational aerobic athletes (21 +/- 3 years). Design: A prospective experimental study. All PCS athletes were compared with the reference group at the beginning of the study. Six of the PCS athletes were subsequently measured before and after a subsymptom threshold aerobic exercise treatment program. Main Measures: Exercise treadmill test during which blood pressure (BP), minute ventilation ((V)over dotE), end-tidal CO2 (PETCO2), and CBF velocity (CBFV, by transcranial Doppler) were measured. Results: Participants with PCS had significantly lower. (V)over dot (by 18%) and greater PETCO2 (5%) and CBFV (14%) versus the reference group at similar workloads in association with appearance of symptoms and premature exercise cessation. Subthreshold exercise normalized. VE, PETCO2, CBFV and exercise tolerance. Before treatment, PCS had low CO2 sensitivity that blunted their exercise ventilation. CO2 sensitivity and ventilation improved after exercise treatment. Conclusion: Some PCS patients have exercise intolerance due to abnormal CBF regulation that may be the result of concussion-induced altered sensitivity to CO2. Return of normal CBF control and exercise tolerance may be physiological markers of recovery from concussion.
引用
收藏
页码:215 / 224
页数:10
相关论文
共 72 条
[1]  
[Anonymous], 2006, ACSMS GUID EX TEST P
[2]   Dynamic cerebral autoregulation remains stable during physical challenge in healthy persons [J].
Brys, M ;
Brown, CM ;
Marthol, H ;
Franta, R ;
Hilz, MJ .
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, 2003, 285 (03) :H1048-H1054
[3]   The effect of age and gender on heart rate variability after endurance training [J].
Carter, JB ;
Banister, EW ;
Blaber, AP .
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 2003, 35 (08) :1333-1340
[4]   Functional abnormalities in symptomatic concussed athletes: an MRI study [J].
Chen, JK ;
Johnston, KM ;
Frey, S ;
Petrides, M ;
Worsley, K ;
Ptito, A .
NEUROIMAGE, 2004, 22 (01) :68-82
[5]   Heart rate variability interventions for concussion and rehabilitation [J].
Conder, Robert L. ;
Conder, Alanna A. .
FRONTIERS IN PSYCHOLOGY, 2014, 5
[6]   The Female Athlete: The Role of Gender in the Assessment and Management of Sport-Related Concussion [J].
Covassin, Tracey ;
Elbin, R. J. .
CLINICS IN SPORTS MEDICINE, 2011, 30 (01) :125-+
[7]   Traumatic cerebral vascular injury: The effects of concussive brain injury on the cerebral vasculature [J].
Dewitt, DS ;
Prough, DS .
JOURNAL OF NEUROTRAUMA, 2003, 20 (09) :795-825
[8]   Passive and active exercises increase cerebral blood flow velocity in young, healthy individuals [J].
Doering, TJ ;
Resch, KL ;
Steuernagel, B ;
Brix, J ;
Schneider, B ;
Fischer, GC .
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION, 1998, 77 (06) :490-493
[9]   Impaired autoregulation of cerebral blood flow in an experimental model of traumatic brain injury [J].
Engelborghs, K ;
Haseldonckx, M ;
Van Reempts, J ;
Van Rossem, K ;
Wouters, L ;
Borgers, M ;
Verlooy, J .
JOURNAL OF NEUROTRAUMA, 2000, 17 (08) :667-677
[10]   Regulation of middle cerebral artery blood velocity during dynamic exercise in humans: influence of aging [J].
Fisher, James P. ;
Ogoh, Shigehiko ;
Young, Colin N. ;
Raven, Peter B. ;
Fadel, Paul J. .
JOURNAL OF APPLIED PHYSIOLOGY, 2008, 105 (01) :266-273