Haider Mohammad Nadir, Johnson Blair D, Horn Emily C, Leddy John J, Wilber Charles G, Reed Emma L, O'Leary Morgan, Bloomfield Adam, Decezaro Larissa L, Willer Barry S
UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States.
Department of Neuroscience, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States.
Front Neurol. 2020 Sep 30;11:547126. doi: 10.3389/fneur.2020.547126. eCollection 2020.
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). Retrospective nested case-control. University laboratory. CH ( = 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 ( = 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. 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. 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. At baseline, CH had a lower resting HR than CN (62.3 ± 11 bpm vs. 72.9 ± 12, = 0.034). CH had a different HR response to FC than CN (+8.9% change from baseline in CH vs. -7.5% in CN, = 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, = 0.048). There were no significant group differences over time in RRI ( = 0.106), HF ( = 0.550) or LF:HF ratio ( = 0.053). 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.
据报道，在与运动相关的脑震荡（SRC）后，使用心率变异性（HRV）量化的心脏自主神经系统（ANS）反应减弱。研究表明，这种情况在临床恢复后仍会持续。本研究比较了有SRC远期病史（>1年前，脑震荡病史：CH）的学生运动员与无SRC终生病史（无脑震荡史：CN）的学生运动员的心脏副交感神经反应。回顾性巢式病例对照研究。大学实验室。CH组（n = 9，18.3±2岁，44%为男性，受伤后中位数为2年）是有1年多前脑震荡远期病史的学生运动员。CN组（n = 21，16.7±3岁，67%为男性）是无脑震荡终生病史的学生运动员。排除标准包括服用可能影响ANS功能的药物、过去一年内有脑震荡史、持续的脑震荡症状、中度至重度脑损伤终生病史以及超过3次脑震荡的终生病史。参与者在仰卧休息10分钟后，在受控环境中佩戴三导联心电图进行3分钟的面部冷却（FC）测试。测量心率（HR）、R-R间期（RRI）、RRI连续差值的均方根（RMSSD）、高频（HF）以及低频与HF比值（LF:HF）。在基线时，CH组的静息心率低于CN组（62.3±11次/分钟对72.9±12次/分钟，P = 0.034）。CH组对FC的心率反应与CN组不同（CH组相对于基线变化+8.9%，而CN组为-7.5%，P = 0.010）。CH组对FC的RMSSD增加幅度也小于CN组（CH组相对于基线变化+31.8%，而CN组为+121.8%，P = 0.048）。RRI（P = 0.106）、HF（P = 0.550）或LF:HF比值（P = 0.053）随时间的组间差异无统计学意义。与无脑震荡终生病史的运动员相比，有脑震荡远期病史的无症状学生运动员对FC的心脏副交感神经反应减弱。这些数据表明，从SRC临床恢复后，对生理应激源的自主神经反应受损持续的时间比之前报道的更长。
