Sport-Related Concussion Induces Transient Cardiovascular Autonomic Dysfunction
AJP Regulatory Integrative and Comparative Physiology
Published online on February 01, 2017
Abstract
Recent evidence suggests that concussions may disrupt autonomic cardiovascular control. This study investigated the initial effects of concussion on cardiovascular function using three autonomic reflex tests. Twenty three recreational athletes (12 females, 11 males) were divided into concussed (n = 12) and control (n = 11) groups. Concussed participants performed forced breathing, standing and Valsalva autonomic tests four times: 1) within 48 hours of injury, 2) 24 hours later, 3) 1 week after injury and 4) 2 weeks after injury. The controls performed the same tests on the same schedule. Differences in heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) responses to the tests were continuously measured using finger photoplethysmography and were analyzed using repeated measures MANOVAs and ANOVAs. Within 48 hours of injury, the concussed group had significantly greater resting SBP (t21 = 2.44, P = 0.02, d = 1.03), HR (t21 = 2.33, P = 0.03, d = 1.01) and SBP responses to standing (t21 = 2.98, P = 0.01, d = 1.24), and 90% SBP normalization times (t21 = 2.64, P = 0.02, d = 1.10) after the Valsalva, but those group differences subsided 24 hours later. There was also a significant interaction with the HR responses to forced breathing (F3,60 = 4.13, P = 0.01, p2 = 0.17), indicating the concussed responses declined relative to the control's over time. The results demonstrate that concussion disrupted autonomic cardiovascular control and that autonomic reflex tests are practical means by which to evaluate that dysfunction.