Coffman Colt A, Harrison Adam T, Kay Jacob J M, Holloway Jeffrey P, LaFountaine Michael F, Moore Robert Davis
Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
Department of Pediatrics-School of Medicine, University of South Carolina, Columbia, SC 29209, USA.
J Clin Med. 2021 Feb 2;10(3):528. doi: 10.3390/jcm10030528.
Evidence suggests that factors associated with a family history of neurodegenerative disease (fhNDD) may influence outcomes following a concussion. However, the relevance of these findings in adolescent populations has not been fully explored. Therefore, the present study sought to evaluate the relationship between fhNDD and neurological outcomes following an adolescent concussion. Data from a local pediatric concussion clinic were used to compare adolescents with ( = 22) and without ( = 44) an fhNDD. Clinical symptom burden, emotional health, cardio-autonomic function, and cognitive performance were assessed at initial (2 weeks) and follow-up (5 weeks) post-injury evaluations. Cardio-autonomic function was assessed at rest and during isometric handgrip contraction (IHGC). Results indicated no significant group differences in emotional health or cognitive performance. Across evaluations, those with an fhNDD exhibited greater somatic symptom severity, alterations in HRV at rest, and early blunted cardio-autonomic reactivity during IHGC compared to those without an fhNDD. These findings suggest that positive fhNDD is negatively associated with clinical symptomology and cardio-autonomic functioning following an adolescent concussion. Further, these findings encourage clinicians to utilize a comprehensive neurological evaluation to monitor concussion recovery. Future studies should look into exploring the role of specific neurodegenerative processes and conditions on concussion outcomes in adolescents.
有证据表明,与神经退行性疾病家族史(fhNDD)相关的因素可能会影响脑震荡后的预后。然而,这些发现在青少年人群中的相关性尚未得到充分探讨。因此,本研究旨在评估青少年脑震荡后fhNDD与神经学预后之间的关系。来自当地儿科脑震荡诊所的数据被用于比较有(n = 22)和没有(n = 44)fhNDD的青少年。在受伤后的初始(约2周)和随访(约5周)评估中,对临床症状负担、情绪健康、心脏自主神经功能和认知表现进行了评估。在静息状态和等长握力收缩(IHGC)期间评估心脏自主神经功能。结果表明,在情绪健康或认知表现方面,两组之间没有显著差异。在各项评估中,与没有fhNDD的青少年相比,有fhNDD的青少年表现出更严重的躯体症状、静息时心率变异性改变以及在IHGC期间早期心脏自主神经反应迟钝。这些发现表明,阳性fhNDD与青少年脑震荡后的临床症状和心脏自主神经功能呈负相关。此外,这些发现鼓励临床医生采用全面的神经学评估来监测脑震荡的恢复情况。未来的研究应该探索特定神经退行性过程和病症在青少年脑震荡预后中的作用。